OMB No Return of Organization Exempt From Income Tax 990 Form 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. ^ Information about Form 990 and its instructions is at www.irs.9ov/form990. Department of the Treasury Internal Revenue Serace 1545-0047 201-5 0 ,_ _ ., I-or the ZU15 calendar year, or tax year oegmnmg A C Name of organization Doing business as Check if applicable B Address change Number and street (or P 0 box if mail is not delivered to street address ❑ Name change ❑ Final retumAerminated ❑ Amended return initial return 1200 12th Ave S. WA S eattle , Tax-exempt status ° C7 01 N Q c in X 8'. q z LL j Corporation where 2 3 4 5 6 7a b 8 9 10 11 12 13 G Gross receipts $ Kreiger 710 Seattl S Ste. ❑ 4947(a)(1 )4 (insert no) ElTrust ClAssociation C10ther ^ WA 98144 H(b) Are all subordinates included ? ❑ 527 or 550 . Year of formation [:]yes[:] No It "No," attach a list (see instructions) H(c) Group exemption number L science to drive nutritious food change is easy 2015 ^ M State of legal domicile WA in policy and industry practice so that all people can live in places to obtain and exposur e to unhe althy products is limited. Check this box ^ n if the orhanlzation discontinued its oneratlons or disposed of more than 25% of ds net asset.Number of voting members of the governing body (Part IV, line 1a) 3 Number of independent voting members of the governing body (Part VI, line 1b) 4 Total number of individuals employed in calendar year 2015 (Part V, line 2a) 5 Total number of volunteers (estimate if necessary) 6 Total unrelated business revenue from Part VIII, column (C), line 12 7a Net unrelated business taxable income from Form 990-T, line 34 7b Prior Year Contnbutions and grants (Part VIII, line 1h) Program service revenue (Part VIII, line 2g) Investment Income (Part VIII, column (A), lines 3, 4, and 7d) Other revenue (Part VIII, column (A), Iln c^.111s=aed 4 Total revenue - add lines 8 through 11 ust e I P^r^#, 1^^00 A „1tg 12 Grants and similar amounts paid (Part I co n-(A), 1lrier1:3) 14 Benefits paid to or for members (Part IX 15 16a b 17 18 19 Salaries, other compensation, employee its art IX, column (A), If r j5 10) Professional fundraising fees (Part IX, c lumr (Aj-11n n N Total fundraising expenses (Part IX, col n (D) L 804. Other expenses (Part IX, column (A), lip a Total expenses Add lines 13-17 (must equal Part IX, column (A), line 25) Revenue less exp enses Subtract line 18 from line 12 A, 4 3 6 3 0. 0 Current Year 272 , 550 272 , 550. Ine 4r^ 2016 180 , 130. , UT 56 66 , 420. 246 , 550. Be g innin g of Current Year 20 21 22 272 H (a) Is this a group return for subordinates? ❑ Yes ® No Briefly describe the organization ' s mission or most significant activities To act on a1E (206)451-8196 : //www . heal thyfoodamerica . org/ K Form of organization M 10 98144 ❑ 501(c)( ® 501(c)(3) J Website L) 47-2926810 E Telephone number F Name and address of principal officer James 1200 12th Ave. 1 oomiswte City or town, state or province, country, and ZIP or foreign postal code ❑ Application pending I D Employer identification number Healthy Food America Total assets (Part X, line 16) Total liabilities (Part X, line 26) Net assets or fund balances Subtract line 21 from line 20 26 , 000. End of Year 26 000 . 26 000 . c Wrallill Si nature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete Declaration of pr parer (other than offcer) is base Sign ^ Signature of officer Here ^ James Krei all information of which preparer has any knowledge Date er xe tit Director Type or print name and title Paid ^t PnntfType preparer's name Prepay 's signature Preparer H oward Sckolnik Use Only ^ Firm's name Howard Sckolnik CPA ^ Firm's address Scottsdale 8203 E . Sierra Pinta AZ 85255 May the IRS discuss this return with the preparer shown above? (see Instruct) For Paperwork Reduction Act Notice , see the separate instructions. UYA 47-2926810 Page 2 Form 990(2015) Health y Food America Statement of Program Service Accomplishments ❑ Check if Schedule 0 contains a response or note to any line in this Part III I Briefly describe the organization's mission To act on science to drive change in policy and industry practice so that all people can live in places where nutritious food is easy to obtain and exposure to unhealthy products is limited. 2 3 4 Did the organization undertake any significant program services during the year which were not listed on the pnor Form 990 or 990-EV If "Yes," describe these new services on Schedule 0 Did the organization cease conducting, or make significant changes in how it conducts, any program seances? If "Yes," describe these changes on Schedule 0 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported 4a (Code ) (Expenses $ 152 , 695 . including grants of $ ❑ Yes © No ❑ Yes © No ) (Revenue $ Developed a research library of >1000 resources focused on sugar science , including sugar and health, sugar consumption, and sugar consumption reduction policies. Developed educational resources and a series of presentations for academic and lay audiences by translating science on sugar and health. Supported the participation of California attendees at an educational conference to discuss lessons learned from Berkeley's Measure D. 4b (Code 4c (Code_ ) (Expenses $ including grants of $ ) (Revenue $ (Expenses $ including grants of $ ) (Revenue $ 4d Other program services (Describe in Schedule 0.) including grants of $ (Expenses $ 4e Total program service expenses ^ UYA ) (Revenue $ 152,695. Form 990 (2015) Healthy Food America Checklist of Req uired Schedules Form990(2015) 47-2926810 Page 3 Yes Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A Is the organization required to complete Schedule B, Schedule of Contnbutors (see instructions)? Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part / Section 501(c )( 3) organizations . Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes, " complete Schedule C, Part II Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes, " complete Schedule C Part Ill Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If I 2 3 4 5 6 "Yes, " complete Schedule D, Part 1 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes, " complete Schedule D, Part 11 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part Ill 8 9 I 2 X X X 3 4 No X 5 X 6 X 7 X 8 X 9 X 10 X 11a X 11b X 11c X 11d 11e X X 11f X 12a X 12b 13 14a X X X 14b X 15 X 16 X 17 X 18 X Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X, or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes, " complete Schedule D, Part IV Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V 10 If the organization's answer to any of the following questions is 'Yes," then complete Schedule D, Parts VI, 11 a VII, VIII, IX, or X as applicable Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete Schedule D, Part VI b c d e f Did the organization report an amount for investments-other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes, " complete Schedule D, Part VII Did the organization report an amount for investments-program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes, " complete Schedule D, Part VIII Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes, " complete Schedule D, Part IX Did the organization report an amount for other liabilities in Part X, line 25'? If "Yes, " complete Schedule D, Part X Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? 12a b 13 14a b 15 16 17 Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes, and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Is the organization a school described in section 170(b)(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, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes, " complete Schedule F, Parts I and IV Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organizatiodf7'Yes, " complete Schedule F, Parts II and IV Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If "Yes, " complete Schedule F, Parts Ill and IV Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? 18 19 UYA If "Yes, " complete Schedule D, Part X Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes,"complete Schedule D, Parts X/ and Xll If "Yes, " complete Schedule G, Part I (see instructions) Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part/I Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes,"complete Schedule G, Part III 19 X Form 990 (2015) Form990(2015) Healthy Food America Checklist of Re q uired Schedules (continued) 47-2926810 Page 4 Yes 20a b 21 22 23 24 a b c d 25a b 26 27 28 a b c 29 30 31 Did the organization operate one or more hospital facilities? If "Yes, " complete Schedule H If "Yes," to line 20a, 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 IX, column (A), line 1? If "Yes," complete Schedule /, Parts land// Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 27 If "Yes, " complete Schedule 1, Parts I and Ill Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 20027 If "Yes," answer lines 24b through 24d and complete Schedule K If "No,"go to line 25a Did the organization invest any proceeds of tax-exempt bonds beyond 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 bonds? Did the organization act as an "on behalf of' issuer for bonds outstanding at any time during the year? Section 501(c )( 3), 501 ( c)(4), and 501 ( c)(29) organizations . Did the organization engage in an excess benefit transaction with a disqualified person during the year? if "Yes, " complete Schedule L, Part I Is this organization aware that it engaged in an excess benefit transaction with a disqualified person in a pnor year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ7 If "Yes, " complete Schedule L, Part I . Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part// Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part Ill Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions) A current or former officer, director, trustee, or key employee? If "Yes, " complete Schedule L, Part IV A family member 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 member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes, " complete Schedule L, Part IV Did the organization receive more than $25,000 in non-cash contributions? If "Yes,"complete Schedule M Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? if "Yes, " complete Schedule N, Part 1 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part ll 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301 7701-3? If "Yes,"complete Schedule R, Part I . . . . . . . . Was the organization related to any tax-exempt or taxable entity? If "Yes, " complete Schedule R, Part ll, lll, or lV, and Part V, line 1 . Did the organization have a controlled entity within the meaning of section 512(b)(13)7 . If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)7 If "Yes," complete Schedule R, Part V, line 2 Section 501(c )( 3) organizations . Did the organization make any transfers to an exempt non-chantable related organization? If "Yes,"; complete Schedule R, Part V, line 2 . . 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 0 and provide explanations in Schedule 0 for Part VI, lines 11b and 197 Note. All Form 990 filers are required to complete Schedule 0 34 35a b 36 37 38 UYP No 20a 20b X 21 X 22 X 23 24a 24b X X 24c 24d 25a X 25b X 26 X 27 X 28a X 28b X 28c X 30 X 31 X 32 X 33 X 35a X 35b 36 X 37 X 38 X Form 99 0 (2015) 47-2926810 Healthy Food America Statements Regarding Other IRS - Filings and Tax Compliance Form990(2015) ❑ Check if Schedule 0 contains a response or note to any line in this Part V Yes 1 a b c 2 a b 3 a b 4 a b 5 a b c 6 a b 7 a b c d e f g h 8 9 a b 10 a b 11 a b 12 a b 13 a b c 14 a b UYA Page 5 1a Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable lb Enter the number of Forms W-2G included in line 1 a Enter -0- if not applicable Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax 2a Statements, filed for the calendar year ending with or within the year covered by this return . required federal employment tax returns? on line 2a, did the organization file all If at least one is reported Note . If the sum of lines 1 a and 2a is greater than 250, you may be required to e-file (see instructions) Did the organization have unrelated business gross income of $1,000 or more during the year? If "Yes," has it filed a Form 990-T for this year's If "No" to line 3b, provide an explanation in Schedule 0 At any time during the calendar year, did the organization have an interest in, or a signature of other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial No 1 0 Ic X 2b X 3a 3b X account)? If "Yes," enter the name of the foreign country 10See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR) Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? If "Yes," to line 5a or 5b, 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 contributions that were not tax deductible as chartable contributions? If "Yes," did the organization include with every solicitation an express statement that such contributions or 4a X 5a 5b Sc X X 6a X gifts were not tax deductible? Organizations that may receive deductible contributions under section 170(c). Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor' 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 tangible personal property for which it was required to file Form 8282' 7d If "Yes," indicate the number of Forms 8282 filed during the year benefit contract? premiums on a personal funds, directly or indirectly, to pay the organization receive any Did Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required' If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? Sponsoring organizations maintaining donor advised funds . Did a donor advised fund maintained by the 6b sponsoring organization have excess business holdings at any time during the year? Sponsoring organizations maintaining donor advised funds. Did the sponsoring organization make any taxable distributions under section 4966? Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? Section 501(c)(7) organizations. Enter Initiation fees and capital contributions included on Part VIII, line 12 Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities 7a 7b X 7c X 7e 7f 7g 7h X X 0 8 9a 9b 10a 10b Section 501(c )( 12) organizations. Enter 11a Gross income from members or shareholders Gross income from other sources (Do not net amounts due or paid to other sources 11b against amounts due or received from them ) 1041' Form 990 in lieu of Form filing Section 4947( a)(1) non-exempt charitable trusts . Is the organization 12b If "Yes," enter the amount of tax-exempt interest received or accrued during the year insurance issuers. Section 501(c )( 29) qualified nonprofit health Is the organization licensed to issue qualified health plans in more than one state? Note . See the instructions for additional information the organization must report on Schedule 0 Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans 13b Enter the amount of reserves on hand Did the organization receive any payments for indoor tanning services during the tax year? If "Yes," has it filed a Form 720 to rep ort these p ayments? If "No,"provide an explanation in Schedule 0 13c 12a 13a 14a 14b X Form 990 (2015) Form99O(2015) Healthv Food America 47-2926810 Page 6 ^TA^ Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and fora "No" response to line 8a, 8b, or 1Ob below, describe the circumstances, processes, or changes in Schedule 0 See instructions Check if Schedule 0 contains a response or note to any line in this Part VI ❑ Section A. Governin g Bod y and Mana g ement Yes Enter the number of voting members of the governing body at the end of the tax year 1a If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule 0 b Enter the number of voting members included in line 1a, above, who are independent 1b 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? Did the organization delegate control over management duties customarily performed by or under the direct 3 supervision of officers, directors, or trustees, or key employees to a management company or other person? 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? 5 Did the organization become aware during the year of a significant diversion of the organization's assets' 6 Did the organization have members or stockholders? 7 a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? Did the organization contemporaneously document the meetings held or written actions undertaken during 8 the year by the following a The governing body? b Each committee with authority to act on behalf of the governing body? 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes, "provide the names and addresses in Schedule 0 Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code) I a 3 2 X 3 4 5 6 X X X X 7a X 7b X 8a 8b X X 9 X Yes Did the organization have local chapters, branches, or affiliates? If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes' 11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? b Describe in Schedule 0 the process, if any, used by the organization to review this Form 990 12 a Did the organization have a written conflict of interest policy? if "No,"go to line 13 b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? c Did the organization regularly and consistently monitor and enforce compliance with the policy? if "Yes," describe in Schedule 0 how this was done 13 Did the organization have a written whistleblower policy? 14 Did the organization have a written document retention and destruction policy? 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official b Other officers or key employees of the organization . If "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions). 16 a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements? 10 a b No 4 10a X 10b 11a X 12a 12b X X 12c 13 14 X 15a 15b No X X X X X r 16 Section C. Disclosure 17 18 19 20 UYA List the states with which a copy of this Form 990 is required to be filed ^ Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501 (c)(3)s only) available for public inspection Indicate how you made these available Check all that apply. ® Upon request ❑ Other (explain in Schedule 0) ❑ Another's website ❑ Own website Describe in Schedule 0 whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year State the name, address, and telephone number of the person who possesses the organization's books and records ^ (6 02) 9 8 9 - 9 9 9 3 Star Financial Mcimt LLC 5109 82nd St. Ste. 7, #1111 Lubbock, TX 79424 Form 990 (2015) Form 990 (2015) Health y Food America 47-2926810 Page 7 Compensation of Officers , Directors , Trustees , Key Employees, Highest Compensated Employees, and Independent Contractors Check if Schedule 0 contains a response or note to any line in this Part VII ❑ Section A . Officers , Directors , Trustees , Key Employees, and Highest Compensated Employees 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year • 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 definintion of "key employee " • List the organization's five current highest compensated employees (other than an officer, director, trustee , or key employee) who received reportable compensation (Box 5 of Form W-2 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 reportable 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 reportable 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 box it neither the org anization nor an y related or g anization com p ensated an y current officer , direct or, or trustee (C) (A) Name and Title (B) Average Position ( do not check more than one (D) (E) (F) Reportable Reportable Estimated hours per box, unless person is both an compensation compensation from amount of from related other th e or g a niz at io ns c o m p ensation organization (W-211099-MISC) week ( list an officer and a director/trustee) -n related a n 3, organizations n c n; m ,o5 N below dotted o a g o o ) n line) 3 M hours for m v^ `D from the organization and related organizations m N CD (1) ERIC GOROVITZ Secretar y , Director (2) MAXINE HAYES Director (3) JIM KRIEGER President , Executive Director (4) MATIAS VALENZUELA Treasurer , Director (5) (W.2/1099•MISC ) 01.00 X X X X X X 01.00 12.00 2 8.00 01.00 X 94 , 422 . 223 806. X (6) (7) (8) (9) (10) (11) (12) (13) (14) UYA Form 9 90 (2015) Form990(2015) Health y Food America 47-2926810 Page 8 Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (C) (A) Name and Title (B) Average hours per week (list an hours for related organizations below dotted line) 3 ,o 0 (D) Reportable compensation from the organization N M (W211099-MISC) 94 , 422. 223 806. 94 422. 223 806. Position (do not check more than one box, unless person is both an officer and a director/trustee) a o. o ?l 2 N m CD ' OM M 2 in N (D 3 'R 0 (D CD (F) Estimated amount of other c o m pe n sa ti o n from the (E) Reportable compensations from related or g ani za t ions (Vµ211099-MISC) organization and related organizations 0 3 M 5, N d Cs CL (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) lb c d 2 Sub-total ^ Total from continuation sheets to Part VII, Section A ^ Total (add lines lb and 1c) ^ Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization ^ No 3 4 5 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line la? If "Yes, " complete Schedule J for such individual For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes, complete Schedule J for such individual Did any person listed on line la 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 table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax y ear. (A) Name and business address 2 UVA (B) Description of services (C) Compensation Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization ' Form 9 90 (2015) Form 990 (2015) Healthy Food America UEEM Statement of Revenue 47-2926810 F-1 Check if Schedule 0 contains a response or note to any line in this Part VIII (A) Total revenue o E L9 < ,6 E c N o d .0 -5 L • ci M is Federated campaigns Membership dues lb 1c Fundraising events Related organizations Id Government grants (contnbutions) le All other contributions, gifts, grants, and similar amounts not included above If g Noncash contributions included in lines la-1f $ h Total. Add lines la-1f 1a b c d e f 232 40 Page 9 (B) Related or exempt function revenue (C) Unrelated business (D) Revenue excluded from tax under revenue sections 512-514 550 . , 000. 10- 272 , 550. Business Code d 2a b c d e f All other program service revenue g Total. Add lines 2a-2f 2 o 10. Investment income (including dividends, interest, and other similar amounts) Income from investment of tax-exempt bond proceeds Royalties 3 4 5 (i) Real 6a b c d 7a Gross rents Less rental expenses Rental income or (loss) Net rental income or (loss) Gross amount from sales of assets other than inventory 101. 1111. (n) Personal (i) Securities (ii) Other b Less cost or other basis and sales expenses c Gain or (loss) d Net gain or (loss) Iol, m 8 a Gross income from fundraising events (not including $ of contributions reported on line 1c) See Part IV, line 18 b Less direct expenses 0 c a b Net income or (loss) from fundraising events 9 a Gross income from gaming activities See Part IV, line 19 b Less direct expenses c Net income or (loss) from gaming activities 10a Gross sales of inventory, less returns and allowances b Less cost of goods sold c Net income or loss from sales inventory Miscellaneous Revenue a b a b Business Code 11a b c d All other revenue e Total. Add lines 11a-11d 12 UYA Total revenue. See instructions 10. Do' 272 550 . Form 990 (2015) form 990 (2015) 47-2926810 Page 10 Health y Food America Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns All other organizations must complete column (A) Che ck if Schedule 0 contains a resoonse or note to any line in this Part IX Do not include amounts reported on lines 6b, 7b, 8b, 9b, (A) Total expenses and 10b of Part Vlll. n (B) Program service exp enses ( C) Management and g eneral e xp enses (D) Fundraising e xp enses Grants and other assistance to domestic organizations and domestic governments See Part IV, line 21 Grants and other assistance to domestic individuals See Part IV, line 22 Grants and other assistance to foreign organizations, foreign governments , and foreign individuals See Part IV, lines 15 and 16 Benefits paid to or for members I 2 3 4 5 Compensation of current officers , directors , trustees, and key employees Compensation not included above , to disqualified persons (as defined under section 4958 (0(1)) and persons described in section 4958 ( c)(3)(B) Other salaries and wages Pension plan accruals and contributions ( include section 401(k) and 403 ( b) employer contributions) Other employee benefits 6 7 8 9 10 Payroll taxes 94 , 422 . 44 , 904 . 13 , 606 . 35 , 912. 71 , 634 . 53 , 726. 8 , 966. 8 , 942. 10 , 141. 3 , 933. 6 , 024 . 2 1 336. 1 , 378. 535. 2 , 739. 1 , 062. 11 Fees for services (non-employees) a Management b Legal c Accounting d Lobbying e Professional fundraisng services See Part IV, line 17 f Investment management fees 9 Other ( If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11 g expenses on Schedule 0.) 12 Advertising and promotion 13 office expenses 14 Information technology 15 Royalties 16 17 Occupancy Travel 18 Payments of travel or entertainment expenses for any federal, state , or local public officials 19 Conferences , conventions , and meetings 20 21 22 Interest Payments to affiliates Depreciation , depletion , and amortization 23 Insurance 24 Other expenses Itemize expenses not covered above (List miscellaneous expenses in line 24e . If line 24e amount exceeds 10 % of line 25 , column (A) amount , list line 24e . . . . . 5 , 952. 5 , 952. 2 , 211. 2 , 211. 4 , 547. 6 , 778. 4 , 547. 8 , 691. 5 , 162. 1 , 181. 2 , 348. 21 , 475 . 2 , 625. 12 , 755. 2 1 625. 2 , 919. 5 , 801. 13 , 838. 13 , 838. . . . . . . . . . 6 778. 303. 303. expenses on Schedule O ) a Research b c d e All other expenses 25 Total functional ex penses . Add lines 1 throug h 24e 26 Joint costs . Complete this line only if the organization reported in column ( B) joint costs from a combined educational campaign and fundraising solicitation Check if following SOP 98-2 (ASC 958-720) here ^ UYA 246 550 . 152 695 . 37 , 051. 56 , 804. Form 990 (2015) Form 990 (2015) 47-2926810 Healthy Food America ce Sheet P age ❑ Check if Schedule 0 contains a response or note to any line in this Part X I 2 3 4 5 6 Cash - non-interest -beanng Savings and temporary cash investments Pledges and grants receivable, net Accounts receivable, net Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees Complete Part II of Schedule L Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501 (c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L Notes and loans receivable, net Inventories for sale or use 9 Prepaid expenses and deferred charges 10 a Land, buildings, and equipment cost or other basis Complete Part VI of Schedule D 10a 10 b Less accumulated depreciation Investments - publicly traded securities 11 12 Investments - other securities See Part IV, line 11 13 Investments - program-related See Part IV, line 11 14 Intangible assets 15 Other assets See Part IV , line 11 16 Total assets . Add lines 1 throu g h 15 ( must eq ual line 34 ) 17 Accounts payable and accrued expenses 18 Grants payable 19 Deferred revenue 20 Tax-exempt bond liabilities Escrow or custodial account liability Complete Part IV of Schedule D 21 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons Complete Part II of Schedule L 23 Secured mortgages and notes payable to unrelated third parties 24 Unsecured notes and loans payable to unrelated third parties 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24) Complete Part X of Schedule D 26 Total liabilities . Add lines 17 throu g h 25 U) and complete lines 27 Organizations that follow SFAS 117 (ASC 958), check here 1110. through 29, and lines 33 and 34 . W N 7 8 (A) (B) Beginning of year End of year 1 2 3 4 6 7 8 9 10c 11 12 13 14 15 16 17 18 19 20 21 25 26 Unrestricted net assets 27 Temporarily restricted net assets Permanently restricted net assets Organizations that do not follow SFAS 117 (ASC 958), check here ^ ❑ and complete lines 30 through 34. Capital stock or trust pnncipal, or current funds Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances Total liabilities and net assets /fund balances 28 29 30 31 N 32 W 33 Z 34 UVA 26 , 000. 22 23 24 m N 26 , 000. 5 f4 27 ca 28 29 11 30 31 32 33 34 26 , 000. 26 000. 26 , 000. Form 990 (2015) Form990(2015) Healthy 47-2926810 Page 12 Food America Reconciliation of Net Assets Check if Schedule 0 contains a response or note to any line in this Part XI 1 2 3 4 5 6 7 8 9 10 Total revenue (must equal Part VIII, column (A), line 12) Total expenses (must equal Part IX, column (A), line 25) Revenue less expenses Subtract line 2 from line 1 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) Net unrealized gains (losses) on investments Donated services and use of facilities Investment expenses Prior period adjustments Other changes in net assets or fund balances (explain in Schedule 0) Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line 33, column ( B )) ❑ 1 272 , 550. 2 246 , 550. 3 4 5 6 7 8 9 26 , 000. 10 26 , 000. Financial Statements and Reporting Check if Schedule 0 contains a response or note to any line in this Part XII ❑ Yes Cash ❑ Accrual Accounting method used to prepare the Form 990 ❑ Other If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule 0 2a Were the organization's financial statements compiled or reviewed by an independent accountant? If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both ❑ Both consolidated and separate basis ❑ Separate basis ❑ Consolidated basis independent Were the organization's financial statements audited by an accountant? . b If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated No 1 2a X 2b X basis, or both ❑ Separate basis ❑ Consolidated basis ❑ Both consolidated and separate basis c If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule 0 3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? b If "Yes," did the organization undergo the required audit or audits' If the organization did not undergo the req uired audit or audits, exp lain wh y in Schedule 0 and describe any ste p s taken to underg o such audits UYA 2c 3a 3b Form 990 (2015) SCHEDULE A (Form 990 or 990-EZ) Public Charity Status and Public Support _ Complete if the organization is a section 501(c )( 3) organization or a section 4947( a)(1) nonexempt charitable trust Department of the Treasury Internal Revenue Service OMB No 1545-0047 2015 Pop- Attach to Form 990 or Form 990-EZ. 10. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990. Name of the organization Employer identification number Reason for Public Charity Status (AII organizations must complete this part ) See instructions organization is not a private foundation because it is (For lines 1 through 11, check only one box ) ❑ A church, convention of churches, or association of churches described in section 170 (b)(1)(A)(i). ❑ A school described in section 170 (b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).) ❑ A hospital or a cooperative hospital service organization described in section 170 (b)(1)(A)(iii). ❑ A medical research organization operated in conjunction with a hospital described in section 170(b )(1)(A)(iii). Enter the hospital's name, city, and state. 5 ❑ An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170 (b)(1)(A)(iv). (Complete Part II.) 6 ❑ A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 ❑ 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 ❑ A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 An organization that normally receives (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions-subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975 See section 509(a)(2). (Complete Part III.) 10 ❑ An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 11 ❑ 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 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g a ❑ Type I A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization You must complete Part IV, Sections A and B b ❑ Type II. A supporting organization supervised or controlled in connection with its supported organization ( s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization ( s). You must complete Part IV, Sections A and C. c ❑ 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 ❑ 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 attentiveness requirement ( see instructions ). You must complete Part IV, Sections A and D , and Part V e ❑ Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated , or Type III non-functionally integrated supporting organization. f Enter the number of supported organizations 0 g Provide the following information about the supported organization(s) The 1 2 3 4 (i) Name of supported organization ( ii) EIN (m)Type of organization (described on lines 1-9 above (see instructions)) ( iv) Is the organization ( v)Amount of monetary listed in your governing support ( see document? instructions ) Yes (vi) Amount of other support (see instructions) No (A) (B) (C) (D) (E) Total For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 -EZ. UYA Schedule A (Form 990 or 990 -EZ) 2015 Healthy Fo od America 47-2926810 P ag e 2 Support Schedule for Organizations Described in Sections 170(b )( 1)(A)(iv) and 170 (b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Su pp ort Schedule A ( Form 990 or 990-EZ ) 2015 Calendar year ( or fiscal year beginning in ) jo. a 2011 b 2012 c 2013 d 2014 a 2015 Total I Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 3 The value of services or facilities furnished by a governmental unit to the organization without charge 4 Total. Add lines 1 through 3 5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) Public su pport . Subtract line 5 from line 4 6 Section B. Total Support Calendar year (or fiscal year beginning in) pop. a 2011 b 2012 c 2013 d 2014 a 2015 Total 7 Amounts from line 4 Gross income from interest, dividends, 8 payments received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities, whether or not the business is regularly carried on 10 Other Income Do not include gain or loss from the sale of capital assets (Explain in Part VI.) 11 Total support. Add lines 7 through 10 12 Gross receipts from related activities, etc. (see instructions) 12 13 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 Section C. Com p utation of Public Su pp ort Percenta g e Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) 14 14 15 Public support percentage from 2014 Schedule A, Part II, line 14 15 16 a 33 1/3 % support test-2015. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box and stop here. The organization qualifies as a publicly supported organization lo. b 33 1/3 % support test-2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3 % or more, check this box and stop here. The organization qualifies as a publicly supported organization . , . II. 17a 10%-facts-and-circumstances test-2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14 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 publicly supported organization b 18 UYA , El % M F-1 LI 10%-facts- and-circumstances test-2014 . If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 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 publicly supported organization . . . . . . . . 111. Private foundation . If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions LI Schedule A (Form 990 or 990-EZ) 2015 Healthy Food America 47-2926810 Page3 Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 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 Support Schedule A (Form 990 or 990-EZ) 2015 Calendar year (or fiscal year beginning in) ^ 1 Gifts, grants, contributions, and membership fees received (Do not include any "unusual grants ") 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or business under section 513 Tax revenues levied for 4 the organization's benefit and either paid to or expended on its behalf The value of services or facilities 5 furnished by a governmental unit to the organization without charge 6 Total. Add lines 1 through 5 7a Amounts included on lines 1, 2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1 %ofthe amount on line 13 for the year Add lines 7a and 7b Public support (Subtract line 7c from b c 8 line 6.) Section B . Total Su pp ort ( a ) 2011 ( b ) 2012 ( c ) 2013 ( d ) 2014 ( e ) 2015 72 55 0 . Total 72 55 0 . 272 , 550. 272 , 550. 2 72 , 550. Calendar year (or fiscal year beginning in) ^ a 2011 b 2012 c 2013 d 2014 a 2015 Total 9 Amounts from line 6 272 , 550. 272 , 550. 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 c Add lines 1Oa and 1Ob 11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on Other Income. Do not include gain or 12 loss from the sale of capital assets (Explain in Part VI.) 13 Total support . (Add lines 9, 1 Oc, 11, and 12) 272 , 550. 272 , 550. 14 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 ^ Section C. Com p utation of Public Su pp ort Percenta g e Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) 15 15 % Public support percentage from 2014 Schedule A, Part III, line 15 16 16 % Section D. Com p utation of Investment Income Percenta g e Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) 17 17 % 18 Investment income percentage from 2014 Schedule A, Part III, line 17 18 % 19a 33 113 % support test-2015 . If the organization did not check the box on line 14, and line 15 is more than 3313 %, and line line 17 is not more than 331/3 %, check this box and stop here .The organization qualifies as a publicly supported organization 10- El b 33 1/3 % support test-2014 . If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/3 %, and line 18 is not more than 331/3 %, check this box and stop here .The organization qualifies as a publicly supported organization 10" F^ 20 Private foundation . If the organization did not check a box o n li ne 14, 19a, or 19b, check this box and see instructions ^ ❑ UVA Schedule A (Form 990 or 990 - EZ) 2015 Schedule A (Form 990 or 990-EZ) 2015 Healthy Food America 47-2926810 Page 4 Supporting Organizations (Complete only if you checked a box in line 11 on Part I If you checked 11 a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V ) Section A. All Supporting Organizations 1 2 3a b c 4a b c 5a b c 6 7 8 9a b c 10a b UYA Are all of the organization's supported organizations listed by name in the organization's governing documents' If "No, " describe in Part VI how the supported organizations are designated. If designated by class or purpose, descnbe the designation If historic and continuing relationship, explain Did the organization have any supported organization that 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 organization was described in section 509(a)(1) or (2) Did the organization have a supported organization described in section 501(c)(4), (5), or (6)'? If "Yes," answer (b) and (c) below Did the organization confirm that each supported organization 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 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 Was any supported organization not organized in the United States ("foreign supported organization")? If "Yes" and if you checked 1 la or 1 lb in Part I, answer (b) and (c) below Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If "Yes, " describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) 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) purposes 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 (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (u) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document) Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document? Substitutions only. Was the substitution the result of an event beyond the organization's control? Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (I) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If "Yes, "provide detail in Part Vl. 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 with regard to a substantial contributor? If "Yes, " complete Part I of Schedule L (Form 990 or 990-EZ). Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If "Yes, " complete Part I of Schedule L (Form 990 or 990-EZ). Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))' If "Yes, " provide detail in Part Vl. Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If "Yes, " provide detail in Part VI. Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If "Yes, "provide detail in Part Vl. Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If "Yes,"answer 10b below Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) 1 2 3a 3b 3c 4a 4b 4c 5a 5b Sc A 7 8 9a 9b 9c 10a 10b Schedule A (Form 990 or 990-EZ) 2015 Schedul e A (Form 990 or 990-EZ) 2015 Heal thy Food America 47-2 s (continued) Has the organization accepted a gift or contribution from any of the following persons? 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? A family member of a person described in (a) above? b c A 35% controlled entity of a person described in (a) or (b) above? If "Yes" to a, b, orc, p rovide detail in Part Vl. Section B. Type I Supporting Org an izations 11 a 11a 11b 11c Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the tax year's If "No, " descnbe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization's activities If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If "Yes," explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization Section C. Type II Supporting Organizations No Were a majority of the organization 's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization 's supported organization (s)' If "No, " describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s) Section D . All Type III Supporting Organizations No 1 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 type and amount of support provided during the prior tax year, (ll) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? 2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ll) serving on the governing body of a supported organization? If "No, "explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s) 3 By reason significant income or supported of the relationship described in (2), did the organization's supported organizations have a voice in the organization's investment policies and in directing the use of the organization's assets at all times during the tax year? If "Yes, " describe In Part VI the role the organization's organizations played in this regard Section E. Type III Functionally- Integrated Supporting Organizations 1 a b c 2 a b 3 a b UVA Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions) ❑ The organization satisfied the Activities Test. Complete line 2 below ❑ The organization is the parent of each of its supported organizations. Complete line 3 below ❑ The organization supported a governmental entity Describe in Part VI how you supported a government entity (see instructions) Activities Test Answer (a) and (b) below. Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responslve9If "Yes, " then in Part Vl identify those 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 determined that these activities constituted substantially all of its activities Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If "Yes, " explain In Part Vl the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement Parent of Supported Organizations Answer (a) and (b) below. Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part Vl. Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizatlons'lf "Yes, " describe in Part VI the role played by the organization in this regard Schedule A (Form 990 or 990-EZ) 20115 47-2926810 Page 6 Food America Health Type III Non-Functionally Integrated 509(a )( 3) Supporting Organizations Schedule A (Form 990 or 990-EZ) 2015 1 ❑ Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Ty pe III non-functionall y integ rated supporting organizations must complete Sections A throu g h E. (B) Current Year Section A - Adjusted Net Income (A) Prior Year (optional) 1 1 Net short-term capital gain 2 Recoveries of prior-year distributions 2 3 3 Other gross income (see instructions) 4 4 Add lines 1 through 3 5 5 Depreciation and depletion 6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 7 Other expenses (see instructions) 8 Adjusted Net income (subtract lines 5, 6 and 7 from line 4) 6 7 8 Section B - Minimum Asset Amount (A) Prior Year (B) Current Year (optional) I Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year) 1a a Average monthly value of securities 1b b Average monthly cash bala nces Ic c Fair market value of other non-exempt-use assets 1d d Total (add lines 1 a, 1 b, and 1c) e Discount claimed for blockage or other factors (explain in detail in Part VI) 2 Acquisition indebtedness applicable to non-exempt-use assets 2 3 3 Subtract line 2 from line ld line Enter 1-1/2% of 3 (for greater amount, held for exempt use. 4 Cash deemed 4 see instructions) 5 5 Net value of non-exempt-use assets (subtract line 4 from line 3) 6 6 Multiply line 5 by .035 7 7 R ecov eri es of pri or-year distributions 8 8 Minimum Asset Amount(add line 7 to line 6) Section C - Distributable Amount Current Year 1 I Adjusted net income for prior year (from Section A, line 8, Column A) 2 2 Enter 85% of line 1 3 3 Minimum asset amount for prior year (from Section B, line 8, Column A) 4 4 Enter greater of line 2 or line 3 5 5 Income tax imposed in prior year 6 Distributable Amount. Subtract line 5 from line 4, unless subject to 6 emergency temporary reduction (see instructions) 7 ❑ Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions). Schedule A (Form 990 or 990 - EZ) 2016 UYA Healthy Food America 47-2926810 Page 7 Type III Non-Functionally Integrated 509(a )( 3) Supporting Organizations (continued) Schedule A (Form 990 or 990- EZ) 2 0 1 5 Section D - Distributions I Amounts paid to supported organizations to accomplish exempt purposes 2 3 4 5 6 7 8 9 10 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity Administrative expenses paid to accomplish exempt purposes of supported organizations Amounts paid to acquire exempt-use assets Qualified set-aside amounts (prior IRS approval required) Other distributions (describe in Part VI) See instructions. Total annual distributions. Add lines 1 through 6 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See Instructions Distributable amount for 2015 from Section C, line 6 Line 8 amount divided by Line 9 amount Section E - Distribution Allocations ( see instructions ) Excess Distributions (ii) Underdistributions Pre-2015 (iii) Distributable Amount for 2015 Distributable amount for 2015 from Section C, line 6 Underdistributions, if any, for years prior to 2015 (reasonable cause required-see instructions) Excess distributions car ryover, if an y , to 2015 1 2 3 a b c d e f h i 4 a b c 5 From 2013 From 2014 Total of lines 3a through e Applied to underdlstrlbutlons of prior ears A pp lied to 2015 distributable amount Carryover from 2010 not applied (see instructions) Remainder Subtract lines 3g, 3h, and 31 from 3f. Distributions for 2015 from Section D, line 7 $ Applied to underdistrlbutlons of p rior y ears Applied to 2015 distributable amount Remainder. Subtract lines 4a and 4b from 4. Remaining underdlstributtons for years prior to 2015, if any Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) 6 Remaining underdistributions for 2015 Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions). 7 Excess distributions carryover to 2016. Add lines 3j and 4c. Breakdown of line 7 8 a b c d e UVA Current Year * Excess from 2013 Excess from 2014 Excess from 2015 Schedule A (Form 990 or 990-EZ) 2015 Schedule A (Form 990 or 990-EZ) 2015 jLjGj= UYA Heal thv Food America 47-2926810 Page 8 Supplemental Information . Provide the explanations required by Part II, line 10; Part II, line 17a or 17b, Part III, line 12, Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1, Part IV, Section D, lines 2 and 3, Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b, Part V, line 1; Part V, Section B, line 1e, Part V, Section D, lines 5, 6, and 8, and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.) Schedule A (Form 990 or 990 -EZ) 2015 SCHEDULE C OMB No 154 5- 0047 Political Campaign and Lobbying Activities (Form 990 or 990-EZ) 2015 For Organizations Exempt From Income Tax Under section 501(c ) and section 527 Department of the Treasury Internal Revenue Service 10- Complete if the organization is described below . ^ Attach to Form 990 or Form 990-EZ . • • - ^ Information about Schedule C ( Form 990 or 990-EZ) and its instructions is at www. irs.go v/form990. I If the organization answered " Yes," on Form 990 , Part IV, line 3, or Form 990-EZ , Part V, line 46 (Political Campaign Activities), then • • ' • • • • Section 501(c)(3) organizations Complete Parts I-A and B Do not complete Part I-C Section 501(c) (other than section 501(c)(3)) organizations Complete Parts I-A and C below Do not complete Part I-B Section 527 organizations Complete I-A only If the organization answered " Yes," on Form 990, Part IV, line 4, or Form 990-EZ , Part VI, line 47 ( Lobbying Activities), then • Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A Do not complete Part II-B • Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)) Complete Part II-B Do not complete Part II-A If the organization answered " Yes," on Form 990, Part IV, line 5 (Proxy Tax) (see separate instructions ) or Form 990 -EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then • Section 501 ( c)(4 ) , ( 5) , or (6 ) org anizations Com p lete Part III Name of organization Employer identification number 47-2926810 Healthy Food America Complete if the organization is exempt under section 501(c) or is a section 527 organization. 3 Provide a description of the organization's direct and indirect political campaign activities in Part IV Political expenditures Volunteer hours I 2 3 Enter the amount of any excise tax incurred by the organization under section 4955 Enter the amount of any excise tax incurred by organization managers under section 4955 If the organization incurred a section 4955 tax, did it file Form 4720 for this year? I 2 ^ $ 0. 0 ^ ^ $ $ 0. Complete if the organization is exempt under section 501(c)(3). 4a Was a correction made? ❑ Yes ❑ No ❑ Yes ❑ No b If "Yes," describe in Part IV I'7TIF61 - Complete if the organization is exempt under section 501(c ), except section 501(c)(3). I Enter the amount directly expended by the filing organization for section 527 exempt function activities 2 Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities 3 4 5 ^ $ 0. ^ $ 0. ^ $ 0. Total exempt function expenditures Add lines 1 and 2 Enter here and on Form 11 20-POL line 17b ❑ No ❑ Yes Did the filing organization file Form 1120 -POL for this year' Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing organization made payments For each organization listed, enter the amount paid from the filing organization's funds Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC) If additional space is needed, provide information in Part IV (e) Amount of political (a) Name (b) Address (c) EIN contributions received and (d) Amount paid from promptly and directly filing organization's delivered to a separate funds If none, enter -0- political organization If none, enter -0- (2) (3) (4) (5) (6) For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 - EZ. UYA Schedule C (Form 990 or 990-E2) 2015 47-2926810 Page 2 Healthy Food America Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 ( election under section 501(h)). Schedule C (Form 990 or 990-EZ) 2015 ❑ if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures). B Check ^ ❑ if the filin g org anization checked box A and "limited control" p rovisions a pply Limits on Lobbying Expenditures (a) Filing (b) Affiliated organization's totals group totals (The term " ex p enditures " means amounts p aid or incurred . ) 1 a Total lobbying expenditures to influence public opinion (grass roots lobbying) b Total lobbying expenditures to influence a legislative body (direct lobbying) c Total lobbying expenditures (add lines la and 1b) d Other exempt purpose expenditures e Total exempt purpose expenditures (add lines 1c and 1d) f Lobbying nontaxable amount Enter the amount from the following table in both columns A Check ^ If the amount on line le, column ( a) or (b ) is: Not over $500,000 Over $500,000 but not over $1,000,000 Over $1,000,000 but not over $1,500,000 Over $1,500,000 but not over $17,000,000 Over $17,000,000 g h i j The lobbying nontaxable amount is: 20% of the amount on line 1e $100,000 plus 15% of the excess over $500,000 $175,000 plus 10% of the excess over $1,000,000 $225,000 plus 5% of the excess over $1,500,000 $1,000,000. Grassroots nontaxable amount (enter 25% of line 10 Subtract line 1g from line 1 a If zero or less, enter -0Subtract line 1 f from line 1 c If zero or less, enter -0If there is an amount other than zero on either line 1 h or line 1 i, did the organization file Form 4720 reporting section 4911 tax for this years ❑ Yes 4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.) ❑ No Lobbvina Expenditures Durina 4-Year Averaaina Period Calendar year (or fiscal year beginning in) (a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total 2a Lobbying nontaxable amount b Lobbying ceiling amount (150% of line 2a, column (e)) c Total lobbying expenditures d Grassroots nontaxable amount e Grassroots ceiling amount (150% of line 2d, column (e)) f Grassroots lobbying expenditures UYA Schedule C (Form 990 or 990-EZ) 2015 Schedule C (Form 990 or 990-EZ) 2015 Health Food America 47-2926810 Page 3 Complete if the organization -is exempt under section 501(c)(3) and has NOT filed Form 5768(election unde r secti on 501(h)). For each "Yes, " response on lines la through 1i below, provide In Part IV a detailed description of the lobbying activity Dunng 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 1 a b c d e f 9 h Volunteers? Paid staff or management (include compensation in expenses reported on lines 1 c through 11)? 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's Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? Other activities? Total Add lines 1c through 11 2a b c d Did the activities 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 film org anization incurred a section 4912 tax, did it file Form 4720 for this year'? Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6). Yes No Were substantially all (90% or more) dues received nondeductible by members'? 1 Did the organization make only in-house lobbying expenditures of $2,000 or less? 2 Did the org anization ag ree to carry over lobb yin g and p olitical expenditures from the p nor year? 3 Complete if the organization is exempt under section 501(c )( 4), section 501 ( c)(5), or section I 2 3 501(c )( 6) and if either ( a) BOTH Part III-A, lines I and 2 , are answered " No," OR ( b) Part III-A, line 3, is answered "Yes." I 2 a b c 3 4 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) I 2a 2b 2c 3 4 5 Supplemental I nformation Provide the descriptions required for Part I-A, line 1, Part I-B, line 4, Part I-C, line 5, Part Il-A (affiliated group list), Part II-A, lines 1 and 2 (see instructions), and Part II-B, line 1 Also, complete this part for any additional information UYA Schedule C (Form 990 or 990-EZ) 2015 Healthy Food America Supplemental Information (continued) Schedule C ( Form 990or990 -EZ) 2015 UYA 47-2926810 Page4 Schedule C (Form 990 or 990-EZ) 2015 SCHEDULEJ ( Form 990) Department of the Treasury Internal Revenue Service Compensation Information OMB No 1545-0047 For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees ^ Complete if the organization answered "Yes" on Form 990, Part IV, line 23. ^ Attach to Form 990. ^ Information about Schedule J (Form 990) and its instructions is at www.irs.aov/form990. Name of the organization Healthy Food America Q uestions Re ga rding Compensation 2015 Employer identification number 47-2926810 No Ia b Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990, Part VII, Section A, line 1a. Complete Part II I to provide any relevant information regarding these items ❑ First-class or charter travel ❑ Housing allowance or residence for personal use ❑ Travel for companions ❑ Payments for business use of personal residence ❑ Tax indemnification and gross-up payments ❑ Health or social club dues or initiation fees ❑ Discretionary spending account ❑ Personal services (e g., maid, chauffeur, chef) If any of the boxes on line 1 a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain 2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors, trustees, and officers, including the CEO/Executive Director, regarding the items checked in line 1a? 3 Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's CEO/Executive Director Check all that apply. Do not check any boxes for methods used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III ❑ Compensation committee ❑ Written employment contract ❑ Independent compensation consultant ❑ Compensation survey or study ❑ Form 990 of other organizations ❑ Approval by the board or compensation committee 4 During the year, did any person listed on Form 990, Part VII, Section A, line 1 a, with respect to the filing organization or a related organization Receive a severance payment or change-of-control payment? Participate in, or receive payment from, a supplemental nonqualified retirement plan'? Participate in, or receive payment from, an equity-based compensation arrangement? If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III. a b c 5 a b i a b 7 8 9 For persons listed on Form 990, Part VII, Section A, line 1 a, did the organization pay or accrue any compensation contingent on the net earnings of The organization? Any related organization? If "Yes" to line 6a or 6b, describe in Part M. For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments not described in lines 5 and 6'? If "Yes," describe in Part III Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III For Paperwork Reduction Act Notice , see the Instructions for Form 990 . UYA 4a 4b 4c Only section 501(c )( 3), 501 ( c)(4), and 501 ( c)(29) organizations must complete lines 5-9. For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation contingent on the revenues of. The organization? Any related organization? If "Yes" to line 5a or 5b, describe in Part III. If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? lb X X 5a 5b X 6a 6b X X 7 8 X X Schedule J ( Form 990) 2015 Page 2 47-2926810 America Officers, Directors , Trustees , Key Employees , and Highest Compensated Employees . Use duplicate copies if additional space is needed. ff^ For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions , on row ( it). Do not list any individuals that are not listed on Form 990 , Part VII Note : The sum of columns ( B)(i)-(m) for each listed individual must equal the total amount of Form 990, Part VII, Section A , line la, applicable column (D) and (E) amounts for that individual Schedule J (Form 990) 2015 ( B) (A) Name and Title JIM KRIEGER (i) lExecutive Directo r ( ii) 2 (i) (ii) 3 (i) (ii) 4 (I) (ii 5 (i) (ii) 6 (i) (ii) 7 8 12 13 (i) (ii) 10 11 14 15 16 UYA 94 , 422 . 223 806 . ( ii) Bonus & incentive compensation ( ui) Other reportable compensation ( C) Retirement and other deferred compensation (D ) Nontaxable benefits 2 C 389. 5 , 664 . ( E) Total of columns (B)(i)-(D) ( F) Compensation in column ( B) reported as deferred in prior Form 990 96 , 811. 229 470. (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) 9 Breakdown of W-2 and / or 1099 - MISC compensation (i) Base compensation (i) (ii) (i) (ii) (i) (ii) Schedule J (Form 990) 2015 Healthy Food America Supplemental Information Schedule J (Form 990) 2015 47-2926810 Page 3 Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II Also complete this part for any additional information Related organization set the Executive Director and staff compensation(using 990s, compensation studies, approval of the Board, and an employment contract for the ED; using compensation studies, external compensaltion consultant, and em^lo=ment contrasts fob r-es t of st aff ) UYA Schedule J (Form 990) 2015 Supplemental Information to Form 990 or 990 -EZ SCHEDULE 0 (Form 990 or 990 - EZ) Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. ^ Attach to Form 990 or 990- EZ. Department of the Treasury Internal Revenue Service Name of the organization OMB No 1545-0047 201 5 Op en Insp e ction Information about Schedule 0 (Form 990 or 990 - EZ) and Its instructions is at www irs gov/form990 Employer identification number 47-2926810 Healthy Food America Part VI #11 Electronic copies of this tax return have been circulated to members of the governing board. Part VI #19 Upon written request the Organization's governing documents, conflict of interest policy and financial Part VI, sect. B, # statements will be made available 12c At its annual Board meetings the organization reviews it conflict reporting requiremnts. For Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 -EZ. UYA Schedule 0 (Form 990 or 990-EZ) (2015) Sc hedule 0 ( Form 990 or 990-EZ) (2015) Name of the organization Employer identification number 47-29268 Healthy Food Ame Part IX Line llg Consultant Total UYA expenses - $4547 00 Program service expenses - $4547 00 Mgmt and general expenses - $0 00 Fundraising expenses - $0 00 Schedule 0 (Form 990 or 990-EZ ) ( 2015) OMB No 1545-0047 SCHEDULE (Form 990 ) Related Organizations and Unrelated Partnerships R 2015 10, Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b , 36, or 37. 110, Attach to Form 990. Department of the Treasury Internal Revenue Service t . - Name of the organization . Employer identification number 47 - 2926810 Health y Food America W;MW . 10- Information about Schedule R (Form 990 ) and its instructions is at www.irs.gov /form99O. Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33. ( a) Name , address , and EIN ( if applicable ) of disregarded entity (b) Primary activity (c) Legal domicile (state or foreign country) (d ) Total income ( e) End-of-year assets (f) Direct controlling entity (2 ) 3) _L (4) (5) (6) Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt oroanizations durina the tax vear_ ( a) Name, address, and EIN of related organization (b) Primary activity (c) Legal domicile (state or foreign country) (d ) Exempt Code section ( e) Public charity status (if section 501(c)(3)) (f) Direct controlling entity (g) Section 512(bl(13) controlled entity? Yes (1) Action For Health 1200 12th Ave S Ste. No Food 710 Seattle, WA 98144 47-1975156 utrition Education A 501C-4 (2) _(4) (5) (6) (7) For Paperwork Reduction Act Notice , see the Instructions for Form 990. UYA Schedule R (Form 990) 2015 47-29268 10 Healthy Food America Part IV, line 34 on Form 990, answered "Yes" Identification of Related Organizations Taxable as a Partnership Complete if the organization year during the tax partnership treated as a organizations because it had one or more related Schedule R (Form 990) 2015 (a) Name, address , and EIN of organization (b) Primary activity (c) Legal domicoor (state r forei g n country) (d ) Direct controlling entity ry ( e) Predominant income ( related , unrelated, excluded from tax under sections 512-514) (f) Share of total income (h) (g) Share of end-of- psproportonate allocat ons 2 yyear assets Yes (1) Code V - UBI amount in box 20 of Schedule K-1 (Form 1065) No U) General or mana g in g partner? Yes Page 2 (k) Percentage ownershipP No 1 0.000000 (2) 0.000000 (3) 0.000000 (4) 0.000000 (5) 0.000000 (6) 0.000000 (7) 0 000000 Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, Ine 34 because it had one or more related or anlzatlons treated as a cor oration or trust durin a the tax ear. ( a) Name , address, and EIN of related organization (b) Primary activity (c) Legal domicile (state orforeign country) (d) Direct controlling entity (e) Type of entity (Ccorp,Scorp,ortnst) (f) Share of total income (g) Share of end-of-year assets (h) Percentage ownership h) Section 512(b)(13) controlled enti ty? Yes No (1) 0.00000 (2) 0.00000 (3) 00000 (4) 0.00000 (5) 0.00000 (6) 0.00000 (7) 0.00000 Schedule R (Form 990) 2015 Uvn Schedule R (Form 990) 2015 Healthy Food America 47-2926810 Page 3 97Mt Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36 Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule. 1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV? . a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity b Gift, grant, or capital contribution to related organization(s) c Gift, grant, or capital contribution from related organization(s) d Loans or loan guarantees to or for related organization(s) e Loans or loan guarantees by related organization(s) f g h i j Dividends from related organization(s). Sale of assets to related organization(s) . Purchase of assets from related organization(s) Exchange of assets with related organization(s) Lease of facilities, equipment, or other assets to related organization(s) k I m n o Lease of facilities, equipment, or other assets from related organization(s) Performance of services or membership or fundraising solicitations for related organization(s) Performance of services or membership or fundraising solicitations by related organization(s) Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) Sharing of paid employees with related organization(s) . Yes . 1a 1b 1c Id le X X X X X if 1g 1h 1i 1j X X X X 1k 11 1m in 10 . 1 1q p Reimbursement paid to related organization(s) for expenses q Reimbursement paid by related organization(s) for expenses o X X X X X X X 1r r Other transfer of cash or property to related organization(s) . . X 1s s Other transfer of cash or property from related organization(s) X 2 If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds. (a) Name of related organization 1 Action For Healthy Food ( 2) Action For Health y Food (b) Transaction type (a-s) J (c) Amount involved (d) Method of determining amount involved 21 475. Salar 180 129. Based ime s pent (3) (4) (5) (6) UVA Schedule R (Form 990) 2015 Schedule R (Form 990) 2015 47- 2 9 26810 Healthy Food America Page 4 FMM Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37 Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related or ganization bee instructions regarding exclusion for cert ain Investment partnerships. (a) Name, address, and EIN of entity (b) Primary activity (c) Legal domicile (state or foreign country) (d ) Predominant income (related, unrelated, excluded from tax under sections 512-514) (e) Are all partners section 501(c)(3) organizatons7 Yes No (f) Share of total income (g) Share of end-of-year assets (h ) Disproportionate allocations) Yes No (I) Code V - UBI amount in box 20 of Schedule K-1 (Form 1065) U) General or managing partner? Yes (k) Percentage ownership No (1) 0.000000 (2) 0.000000 (3) 0.000000 (4) 0.000000 (5) 0.000000 (6) 0.000000 (7) 0.000000 (8) 0.000000 (9) L 000000 (10) 0.000000 (11) 0.000000 (12) 0.000000 (13) 0.000000 (14) 0.000000 15 0.000000 (16) 0.000000 UVA Schedule R (Form 990) 2015 Schedule R (Form 990) 2015 Healthy Food America 47-2926810 Page 5 Supplemental Information Provide additional information for responses to questions on Schedule R (see instructions). UYA Schedule R (Form 990) 2015