?Form 990 Depaitment of the Treasury Internal Revenue SerVice A For the 2018 calendar year, or tax year beginning 2949336200802 9 OMB No 1545-0047 Return of Organization Exempt From Income Tax 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 publi Go to for instructions and the latest information. 2018, and ending 71/8 Open to Public Inspection Check If applicable Name of organizationgRASSROOT I I TUTE OF HAWAI I I I NC Employer identification number Address change Dorng busmess Name change Number and street (or 0 box if mail is not delivered to street address) Room/swte Telephone number Initialretum 1050 BISHOP ST 508 (808)591?9193 Final retum/terminated City or town, state or province. country, and ZIP or foreign postal code Amended return HONOLUIJU I I 9 68 1 3 Gross TECEIPIS Application pending Name and address 0" officer. Hta) Is this a group return for subordinates? Yes No WILLIAM AKINA, 1050 BISHOP ST #508, HONOLULU, HI 96813 H(b) Are all subordinates included?7DYes No Tax-exempt status 121 501(c)(3) 1:1 501(c) (insert no) El 4947(a)(1) or 1:1 527) attach a (see Website: I H(c) Group exemption number Form of organization Corporation Trust Assomation Other I I Year of formation 2 0 0 1 State of legal domic?e I - Summary 1 Briefly describe the organization's mission or most significant actiVities: Egg; 1.9-2914. .195!? BE. 13.5.3.9 11-211113. ,5 93199113919 8 2 Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets. 8 3 Number of voting members of the governing body (Part VI, line 1aNumber of independent voting members of the governing bod (P B?ng . . 4 6 23:9 5 Total number of indiViduals employed in calendar year 2018 (Fag, line 2a) .8 5 6 Total number of volunteers (estimate if necessary2,019.? 6 3 7a Total unrelated busmess revenue from Part column (C), lire 12 7a 0, Net unrelated busmess taxable income from Form 990-T, line PnorY Current Year a, 8 Contributions and grants (Part line 1h) . 67 6, 723. 7 2 2 35. 9 Program serVice revenue (Part line 29Investment income (Part column (A), lines Other revenue (Part column (A), lines 5, 6d, 8c. 9c, 10c, and 11e) . 12 Total revenue?add lines 8 through 11 (must equal Part column (A), line 12Grants and Similar amounts paid (Part IX, column (A), lines 1?3) . 14 Benefits paid to or for members (Part IX, column (A), line 4) . . 3 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5?10168 Professional fundraismg fees (Part IX, column (A), line He) . . . Total fundraising expenses (Part IX, column (D), line 25) 2 3 . 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24eTotal expenses. Add lines 13?1 7 (must equal Part IX, column (A). line 25Revenue less expenses. Subtract line 18 from line Beginning of Current Year End of Year 313 20 TotatassetS(PartX line16) 109,513. 203,404. ?13 21 Total liabilities (Part X, line 26?32 Net assets or fund balances. Subtract line 21 from line Sig?ature Block Under penalties of true, correct, and Iete Declarat'ion of preparer (other than officer) is based on all information of which preparer has any knowledge I ?gury, I declare that have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is I MM Sign Signature of officer Date Here WILLIAM AKINA, PRESIDENT I Type or print name and title - I I I Paid PrinI?Type preparer's name Pre er's signature 7am Check if PTIN Preparer GERALD USHIJIMA ?m '4 self-employed P01356124 Use Only Fmaename Y. USHIJI A I Fiji'sEiN? 99?0230347 rm?lagaddres? 1110 UNIVERSITY AVE STE 508, HONOLUQL HI 96826?1508 Phoneno (808)949?5588 May the IRS discuss this return With the preparer shown above? (see instructions) For Papenivork Reduction Act Notice, see the separate instructions. BAA REV 05/20l19 PRO (XI Yes No Form 990 (2013) Form 990 (2018) Page 2 :Part Statement of Program Service Accomplishments . . . . . . . . . . . . . 1 Briefly describe the organization's missmn: 2 the organization undertake any Significant program servuces during the year which were not listed on the [:lYes-No If ?Yes,? describe these new services on Schedule 0. 3 Did the organization cease conducting, or make significant changes in how It conducts, any program If ?Yes," describe these changes on Schedule 0. 4 Describe the organization's program servrce accomplishments for each of its three largest program servuces, 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 including grants of (Revenue 0 4b (Code (Expenses Including grants of (Revenue 40 (Code (Expenses Including grants of (Revenue 4d Other program services (Describe In Schedule 0.) (Expenses including grants of (Revenue 4e Total program service expenses REV 05(20119 PRO Form 990 (2018) Form 996 (2013) Page 3 Checklist of Required Schedules Yes No 1 Is the organization described In sectIon 501(c)(3) or 4947(a)(1) (other than a prIvate foundation)? If "Yes," complete Schedule the organization reqwred to complete Schedule B, Scnedule of Contributors (see instructions)? . . . 2 3 Did the organization engage In direct or IndIrect poIItIcaI campaign actIVItIes on behalf of or In opposmon to candIdates for pubIIc of'fIce? lf "Yes, complete Schedule C, Partl . . . . . . . . . . . . 3 4 Section 501(c)(3) organizations. the organIzatIon engage In lobbyIng actIVItIes, or have a sectIon 501(h election In effect durIng the tax year? lf ?Yes, complete Schedule Part llthe organIzatIon a section 501(c)(4), or 501(c)(6) organIzatIon that receres dues, assessments. or amounts as de?ned In Revenue Procedure 98- 19? If ?Yes, complete Schedule C, Part 5 6 the organIzatIon maIntain any donor adVIsed funds or any funds or accounts for which donors have the right to prowde adVIce on the dIstributIon or Investment of amounts in such funds or accounts? If "Yes,"completeScheduleD,Partl . . . . . . . . . . . . . . . . . . . . . . . . 6 7 the organIzatIon recere or hold a conservatlon easement, IncludIng easements to preserve open space, the enVIronment, hIstorIc land areas, or hIstorIc structures? If "Yes, complete Schedule D, Part II . . 7 8 the organizatIon maintaIn collections of works of art, hIstorIcal treasures, or other assets? If "Yesthe organlzatIon report an amount in Part X, Me 21, for escrow or custodial account IIabilIty, serve as a custodian for amounts not lIsted In Part or prowde credIt counseIIng, debt management, credIt repaIr, or debt negotIatIon services? If "Yes, complete Schedule D, Part Did the organIzatIon, dIrectIy or through a related organlzatlon, hold assets In temporarlly restricted endowments, permanent endowments, or quaSI? e?ndowments? If "Yes, complete Schedule D, Part . . 10 11 If the organization?s answer to any of the followmg questIons IS ?Yes," then complete Schedule D, Parts VI, VII, IX, or as applicable. 1 a the organIzatIon report an amount for land, bmldings, and eqUIpment In Part X, lIne 10? If "Yes,? completeScheduleD,PartVl . . . . . . . . . . . . . . . . . . . . . . 11a Did the organizatIon report an amount for Investments? other securItIes In Part X, IIne 12 that Is 5% or more of Its total assets reported in Part X, We 16? lf "Yes," complete Schedule D, Part VII . . . . . . . 11b the organIzation report an amount for Investments? p?rogram related In Part X, Me 13 that Is 5% or more of its total assets reported in Part X, 16? If "Yes, complete Schedule D, Part . . . . . . 11c the organIzatIon report an amount for other assets In Part X, Me 15 that Is 5% or more of Its total assets reported in Part X, Me 16? If "Yes, complete Schedule D, Part IX . . . . 11d the organizatIon report an amount for other In Part X, line 25? If "Yes, complete Schedule D, Part 11e the organizatIon' 3 separate or consolidated financial statements for the tax year Include a footnote that addresses the organIzatIon's for uncertaIn tax positIons under FIN 48 (A80 740)? If "Yes,? complete Schedule D, Part 11f 123 the organizatIon obtaIn separate, independent audIted fInanCIal statements for the tax year? If ?Yes,? complete ScheduleD, Parts 12a Was the organizatlon Included In consolldated, Independent audIted fInanCIaI statements for the tax year? If ?Yes," and if the organization answered "No? to line 123, then completing Schedule D, Parts XI and Is optional 12b 13 Is the organIzatIon a school described in sectIon If ?Yes," complete Schedule . . . . 13 14a the organIzatIon maIntain an of?ce, employees, or agents outside of the UnIted States? . . . . . 14a Did the organizatIon have aggregate revenues or expenses of more than $10,000 from grantmakIng, fundraIsmg, 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 the organIzation report on Part IX, column (A), line 3, more than $5,000 of grants or other to or for any foreIgn organizatIon? lf "Yes, complete Schedule F, PanDid the organIzation report on Part IX, column (A), Me 3, more than $5,000 of aggregate grants or other aSSIstance to orfor foreIgn IndIviduaIs? If "Yes, complete Schedule F, Parts anleDid the organlzation report a total of more than $15,000 of expenses for professional fundraising serVIces on Part IX, column (A), lines 6 and 11e? If ?Yes, complete Schedule G, Part I (see instructIons?18 Old the organIzatIon report more than $15, 000 total of fundraISIng event gross Income and contrIbutIons on Part IInes 1c and 8a? If "Yes, complete Schedule G, Part the organIzatIon report more than $15,000 of gross Income from gamIng actIVIties on Part line 9a? If ?Yes, complete Schedule G, Part . . . . . . . . 19 20 a the organIzation operate one or more hospItal If "Yes," complete Schedule ?Yes" to line 20a, dId the organIzation attach a copy of its audited ?nancial statements to this return? . 20b 21 Did the organIzation report more than 000 of grants or other assistance to any domestic organization or domestlc government on Part IX, column (A), IIne 1? If); m?gamolete Schedule I, Parts land ll . . . . 21 Form 990 (2018) Form 996 (2018) ?Part IV Checklist of Required Schedules (continued) Page 4 Yes No 22 Did the organization report more than $5,000 of grants or other a55istance to or for domestic individuals on Part IX, column (A), line 2? If "Yes,? complete Schedule I, Parts I and 22 23 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 ScheduleJ . . . . . 23 24a 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, 2002? If "Yes, answer lines 24b through 24d and complete Schedule K. If "No, go to line 25a . 24a Did the organization invest any proceeds of tax- e-xempt bonds beyond a temporary period exception? . 24b Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? . 24c Did the organization act as an ?on behalf of" issuer for bonds outstanding at any time during the year? . 24d 253 Section 501(c)(3), 501 and 501 (c)l29) organizations. Did the organization engage in an excess benefit transaction With a disqualified person during the year? If "Yes, complete Schedule L, Part! . 25a Is the organization aware that it engaged in an excess benefit transaction With a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or If "Yes, complete Schedule L, Part! . . . . 25!) 26 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 ll 26 27 Did the organization prowde a grant or other a35istance 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 . 28 Was the organization a party to a busmess transaction With one of the followmg parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If "Yes, complete Schedule L, Part IV 28a A family member of a current or former officer, director, trustee, or key employee? If ?Yes, complete ScheduleL,Parth .. . .. . . 28b 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 28c 29 Did the organization receive more than $25,000 in non-cash contributions? If ?Yes, complete Schedule 29 30 Did the organization receive contributions of art, historical treasures, or other Similar assets, or qualified conservation contributions? If ?Yes," complete Schedule . 30 31 Did the organization liqUidate, terminate, or dissolve and cease Operations? If "Yes, complete Schedule N, Part! 31 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301 .7701-2 and 301. 7701 If "Yes, complete Schedule R, Partl. . 33 34 Was the organization related to any tax- -exempt or taxable entity? If ?Yes, complete Schedule H, Part II, oer, and Part V, line 1 34 35a Did the organization have a controlled entity Within the meaning of section 512(b)(13)? . 35a 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)? If ?Yes, complete Schedule Fl, Part v, line 2. 35b 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If ?Yes," complete Schedule R, Part V, line Did the organization conduct more than 5% of its actiwties 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 H, Part Vl 37 38 Did the organization complete Schedule 0 and prowde explanations in Schedule 0 for Part VI, lines 11b and 19? Note. All Form 990 filers are reqUIred to complete Schedule 0. 38 Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule 0 contains a response or note to any line in this Part El Yes No 1a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable . . . 1a 0 Enter the number of Forms included in line 1a. Enter -0- if not applicable . . . . 1b 0 Did the organization comply With backup Withholding rules for reportable payments to vendors and reportable gaming (gambling) Winnings to prize Winners? 1c REV 05l20/19 PRO Form 990 (2018) Form 996 (2018) Statements Regarding Other IRS Filings and Tax Compliance (continued) Page 5 Yes No 23 Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax a. Statements, filed for the calendar year ending With or within the year covered by this return 2a a a If at least one is reported on line 2a, did the organization file all required federal employment tax returns? . 2b Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-fi'le (see instructions) . 9 i 3a Did the organization have unrelated business gross income of $1,000 or more during the year? . 3a If ?Yes," has it filed a Form 990-T for this year? If ?No" to line 3b, provrde an explanation in Schedule 0 . 3b 4a At any time during the calendar year, did the organization have an interest in, or a Signature or other authority over, a Manual account in a foreign country (such as a bank account, securities account, or other finanCIal account)? 43 if ?Yes," enter the name of the foreign country. . i See instructions for filing reqUirements for Form 114, Report of Foreign Bank and Financial Accounts (FEAR). 0 a 5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . 5a Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? 5b If "Yes" to line 5a or 5b, did the organization file Form 8886- . 5c 6a Does the organization have annual gross receipts that are normally greater than $1 00, 000, and did the organization what any contributions that were not tax deductible as charitable contributions?. . Ba If "Yes, did the organization include With every solicnation an express statement that such contributions or gifts were not tax deductible? 6b 7 Organizations that may receive deductible contributions under section 170(c). .. a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods . and services prowded to the payor? . . 7a If ?Yes," did the organization notify the donor of the value of the goods or services prowded? . . 7b Did the organization sell exchange, or otherWIse di5pose of tangible personal property for which it was required to file Form 8282?Yes, indicate the number of Forms 8282 filed during the year . . . . . . . . I 7d I I Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e 1? Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . 7f If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as reqwred? 79 If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-0? 7h 8 Sponsoring organizations maintaining donor advised funds. Did a donor adVIsed fund maintained by the 1] sponsoring organization have excess busmess holdings at any time during the year? . 8 9 Sponsoring organizations maintaining donor advised funds. L. a Did the sponsoring organization make any taxable distributions under section 4966? . 93 Did the sponsoring organization make a distribution to a donor, donor adVIsor, or related person? 9b 10 Section 501(c)(7) organizations. Enter: 3 a Initiation fees and capital contributions included on Part line 12 . . . . . 10a Gross receipts, included on Form 990, Part line 12, for public use of club facmties . 10b a 11 Section 501(c)(12) organizations. Enter. a Gross income from members or shareholders . . . . . . . . . . . . . . 11a 0 a Gross income from other sources (Do not net amounts due or paid to other sources ?a against amounts due or received from them12a Section 4947(a)(1) non-exempt charitable trusts. is the organization filing Form 990 in lieu of Form 1041 12a If ?Yes," enter the amount of tax- -exempt interest received or accrued during the year . . a. 13 Section 501(c)(29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? 133 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 . .1 the organization is licensed to issue qualified health plans . . . . . . . . . . 13b .3 am Enter the amount of reserves on hand . . . . 13c .- 14a Did the organization receive any payments for indoor tanning serVIces during the tax year?. 14a If "Yes, has it filed a Form 720 to report these payments? If 'prowde an explanation in Schedule 0 14b 15 Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year"Yes," see instructions and file Form 4720, Schedule N. 9 16 Is the organization an educational institution subject to the section 4968 eXCIse tax on net investment income? 16 If "Yes," complete Form 4720, Schedule 0. a 1' REV 05I20l19 PRO Form 990 (2018) Form 996 (2018) Page 6 ?PartVl Governance, Management, and Disclosure For each "Yes? response to lines 2 through 7b below, and for a response to line 83, 8b, or 10b below, describe the Circumstances, processes, or changes in Schedule 0. See instnictions. Check if Schedule 0 contains a response or note to any line in this Part VI IZI Section A. Governing Body and Management Yes No 1a Enter the number of voting members of the governing body at the end of the tax yearthere are material differences in voting rights among members of the governing body, or i I if the governing body delegated broad authority to an executive committee or similar "Ii committee, explain in Schedule 0. - Enter the number of voting members included in line 1a, above, who are independent . 1b 6 a. a 2 Did any officer, director trustee, or key employee have a family relationship or a busmess relationship with mgr" any other officer, director, trustee, or key employeeDid the organization delegate control over management duties customarily performed by or under the direct of officers, directors, or trustees, or key employees to a management company or other person? 3 4 Did the organization make any Significant changes to its governing documents Since the prior Form 990 was filed? 4 5 Did the organization become aware during the year of a Significant diversion of the organization?s assets? . 5 6 Did the organization have members or stockholdersDid the organization have members, stockholders, or other pei sons who had the power to elect or appomt one or more members of the governing bodyAre any governance deCiSions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing bodyDid the organization contemporaneously document the meetings held or written actions undertaken during r, - ?t the year by the followmg: a The governing bodyEach committee With authority to act on behalf of the governing bodythere 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,? ?prowde the names and addresses in Schedule 0.. . 9 Section B. Policies (This Section 8 requests information about pO/lCleS not required by the Internal Revenue Code.) Yes No We Did the organization have local chapters, branches, or affiliates"Yes, did the organization have written and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are conSIstent With the organization' 3 exempt purposes? 10b 11a Has the organization proVided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a Describe in Schedule 0 the process, if any. used by the organization to review this Form 990. p? I 12a Did the organization have a written conflict of interest policy? If "No, go to line 13 . . . . 12a Were officers, directors, or trustees, and key employees reqUired to disclose annually interests that could give rise to conflicts? 12b Did the organization regularly and con3istently monitor and enforce compliance with the policy? If "Yes," describe in Schedule 0 how this was done . . . . . . . . . . . . . . . . . . 12c 13 Did the organization have a written whistleblower policyDid the organization have a written document retention and destruction policyDid the process for determining compensation of the followmg persons include a reVieW and approval by i in independent persons, comparability data, and contemporaneous substantiation of the deliberation and desisionThe organization?s CEO, Executive Director, or top management offICIal . . . . . . . . . . . . 15a Other officers or key employees of the organization . . . . . . . . . . . . 15b If ?Yes" to line 15a or 15b, describe the process in Schedule (see instructions). wt;- . 16a Did the organization invest in, contribute assets to, or partICipate in 3 Nil? venture or Similar arrangement ?1 9 4. With a taxable entity during the year?Yes," did the organization follow a written policy or procedure requmng the organization to evaluate its 4?3 as; partICipation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the at? - If i organization?s exempt status With respect to such arrangements16b Section C. Disclosure 17 List the states With which a copy of this Form 990 is required to be filed HI 18 Section 6104 reqUIres an organization to make its Forms 1023 (1024 or 1024-A if applicable), 990. and 990-T (Section 501(c) (3)5 only) available for public inspection. Indicate how you made these available. Check all that apply. El Own web5ite Another's webSite Upon request Other (explain in Schedule 0) 19 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. 20 State the name, address, and telephone number of the person who possesses the organization's books and records WILLIAM AKINA, 1050 BISHOP ST 508, HONOLULU, HI 96813 (808) 591?9193 REV 05l20l19 PRO Form 990 (2018) Form 9.60 (2018) 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 13 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. 0 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. 0 List all of the organization's current key employees, if any. See instructions for definition of ?key employee." 0 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. 0 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. 0 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 followmg order: indiViduaI trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (Cl Posmon (B) (do not check more than one (D) (E) Name and Title Average box, unless person .5 both an Reportable Reportable Estimated hours per Of?cer and a director/trustee) compensation compensation from amount of week (list any 0 7: I 11 from related other hours for a a .3. 35 the organizations compensation related 3 a 8 a; Eli-if c3 , organization from the organizations 9. 3 .3 organization below dotted 2 in and related line) a organizations 3 e. a a a O. CHAI 0 . 0 . 0 . 115,125. 0. 33,205. TREASURER 0. 0. 0. DIRECTOR, VICE CHAIR RECTOR . . . DIRECTOR 0 0 0 -19.) .119.) .111.) ll?) 1.1.1.3.) .114) REV 05/20/19 PRO Form 990 (2018) Form 996 (2018) Page 8 I I Part VII Section A. Officers, Directors. Trustees, Key Employees, and Highest Compensated Employees (continued) (C) Posmon (A) (do not check more than one (D) (E, (F) Name and title Average box, unless person .5 both an Reportable Reportable Estimated hours per otficer and a director/trustee) compensation compensation from amount of week (list any 0 _n from related other hours for the organizations compensation related 3 a 8 1% a organization from the organizations 8. 3' .3 f3 3 organization below dotted I i; and related line) '8 organizations 9. a a a (J. 11.5.) (16) ll?) . .119.) .119.) (20) (21) 12.9.) 12.4.1 .125! 1b Sub-total 115,125. 0. 33,205. Total from continuation sheets to Part VII Section A Total (addlines 1band1c). 115,125. 0. 33,205. 2 Total number of InlelduaIS (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 1 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1a? If ?Yes, complete Schedule for such inciiwdual 4 For any indiwdual listed on line 1a, is the sum of reportable compensation and other compensation from the complete Schedule for such organization and related organizations greater than $150,000? If ?Yes," individual. 5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If ?Yes,' 'complete Schedule for such person Yes I ?a Section B. Independent Contractors 1 Complete this table for your live highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or Within the organization's tax year. (A) Name and busmess address (3) Description of sewices (Cl Compensation 2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization REV 05I20I19 PRO Form 990 l2018) Form 996 (2013) Part Statement of Revenue Check if Schedule 0 contains a response or note to any line In this Part . Page 9 El a 0 ma no" ita?u?(A) Total revenue Related or exempt function revenue (Cl Unrelated bussness revenue (Di Revenue excluded from tax under sections 512?514 Contributions, Gifts, Grants ,7 and Other Similar Amounts SID Federated campaigns . 1a Membership dues 1b Fundraismg events . 1c Related organizations 1d Government grants (contributions) 1e All other contributions. gifts, grants, and amounts not included above 1f 710, 867. Noncash contributions included In lines 1a?1f Total. Add lines 1a?1f . 712,23?. Program Service Revenue 2a EVENTS All other program sewice revenue . Total. Add lines 2a?2f . Busmess Code Go NA 2, 968. 2, 968. 2.968. Other Revenue 6a 0 7a 8a Investment income (including dividends, interest, and other Similar amounts) Income from investment of tax-exempt bond proceeds Royalties 1,260. I Real. (ii) Personal Gross rents Less: rental expenses Rental income or (loss) Net rental income or (loss) Gross amount from sales of (0 secur't'es I (ii) .Other assets other than Inventory Less cost or other basis and sales expenses . Gain or (loss) . Net gain or (loss) Gross income from fundraismg events (not including of contributions See Part IV, line Less: direct expenses . . . . Net income or (loss) from fundraising Gross income from gaming actiwties. See Part IV, line Less: direct expenses. . . . events . Net income or (loss) from gaming activities . . Gross sales of inventory, less returns and allowances . . . a Less: cost of goods sold . . . Net income or (loss) from sales of inventory . . Miscellaneous Revenue Business Code All other revenue . Total. Add lines 11a?1 1d . Total revenue. See instructions a I 9. 716,463. 2,968. 1,260. REV 05I20I19 PRO Form 990 (2018) Form 996 (20 I3) Statement of Functional Expenses Page 1 0 Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Check If Schedule 0 contains a response or note to any Me In thIs Part IX . . . Do not include amounts reported on lines 6b, 7b, I I (A) (B) (C) (D) 815, 9b. and 10b of Part 0 a expenses 1 Grants and other a55Istance to domestIc organIzatIons . and domestIc governments. See Part IV, me 21 2 Grants and other aSSIstance to domestlc .. In IndIVIduals. See Part IV. line 22 .. 3 Grants and other assistance to foreIgn 4 organizatrons, foreign governments, and foreIgn I ., IndiVIduals. See Part IV, lInes 15 and 16 . . 4 Bene?ts paid to or for members 5 CompensatIon of current officers, dIrectors, trustees, and keyemployees - - 115,125. 69,075. 34,538. 11,512. 6 CompensatIon not Included above, to persons (as defined under section 4958(1)(1)) and persons described in sectIon 4958(c)(3)(B) 7 Othersalariesandwages . 125,434. 107,873. 15,052. 2,509. 8 Pension plan accruals and contrIbutIons (include sectIon 401(k) and 403(b) employer contrIbutIonsOtheremployee bene?ts. 51,825. 38,351. 13,474. 0. 10 Payrolltaxes 23,796. 17,371. 4,207. 2,218. 11 Fees for serVIces (non- employees): a Management 48,656. 0. 42,235. 6,421. Legal 3,912. 1,530. 2,382. 0. Lobbying . . Protessmnal fundraising serVIces. See Part IV, 1m 17 . Investment management fees 9 Other. (If Me 119 amount exceeds 10% of MM 25, column (A) amount, lIst lIne 11g expenses on Schedule 0.). Advertising and promotIon 3, 340. 2, 472. 701. 167. 13 Officeexpenses 7,887. 5,827. 1,655. 405. 14 InformatIon technology 8, 988. 6, 471. 2,067. 450. 15 Royaltles . 16 Occupancy 34,918. 25,767. 7,410. 1,741. 17 Travel . . 13,324. 9,898. 3,426. 0. 18 Payments of travel or entertaInment expenses for any federal, state, or local publIc offiCIals 19 Conferences, conventIons, and meetIngs Interest . . 21 Payments to . 22 Depremation, depletIon, and amortIzatIon Insurance10,399. 7,664. 2,735. 0. 24 Other expenses. ItemIze expenses not covered t. 4 4 above (LIst mIscellaneous expenses In lIne 24e. If a .. no .. lIne 24e amount exceeds 10% of Me 25, column II . 41 (A) amount, lIst line 24a expenses on Schedule 013131191111199 1418;; 2,214. 1,438. 776. 27 828. 20, 7 10. 7 118. 0. 1, 661. 1, 250. 411. 0. All otherexpenses 27,944. 3,000. 24,944. 0 25 Total functional Joint costs. Complete thIs IIne only if the organIzation reported in column (8) pm costs from a combIned educatIonaI campaIgn and fundraisin solICItatIon. Check here If followmg OP 958?720) . . REV 05120119 PRO Form 990 (2018) Form 996 (2013) Balance Sheet Page 11 Check if Schedule 0 contains a response or note to any line in this Part . (A) (B) Beginning of year End of year 1 Cash-non-interest-bearing . Savings and temporary cash investments . Pledges and grants receivable, net 3 4 Accounts receivableLoans and other receivables from current and former officers, directors, . . l. trustees, key employees, and highest compensated employees. J, Complete Part II of Schedule . . . 5 6 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 0. sponsoring organizations of section 501(c)(9) voluntary employees' benefICiary a organizations (see instructions). Complete Part II of Schedule 5 a 7 Notes and loans receivable net 7 8 Inventories for sale or use 8 9 Prepaid expenses and deferred charges 9 ?10 Land, buildings, and eqUipment: cost or a a other baSis. Complete Part VI of Schedule 103 Less: accumulated depreciation 10b 3, 961. 1 013. 10c 580. 11 Investments?publicly traded securities . Investments?other securities. See Part IV, line 11 12 13 Investments? p?rogram-related. See Part IV, line 11 . 13 14 Intangible assets . 14 15 Other assets. See Part IV, line 11 . 15 16 Total assets. Add lines 1 through 15 (must equal line 34).Accounts payable and accrued expenses . 10Grants payable . 18 19 Deferred revenue . . 19 20 Tax- -exempt bond liabilities . 20 21 Escrow or custodial account liability. Complete Part IV of Schedule D. 21 3 22 Loans and other payables to current and former officers, directors, 0 trustees, key employees, highest compensated employees, and 0 disqualified persons. Complete Part II of Schedule 22 :3 23 Secured mortgages and notes payable to unrelated third parties 23 24 Unsecured notes and loans payable to unrelated third parties 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part of Schedule 25 26 Total liabilities. Add lines 17 through Organizations that follow SFAS 117 (ASC 958), check here and ,0 3 complete lines 27 through 29. and lines 33 and 34. Life 5 27 Unrestricted net assets . 27 3 28 Temporarily restricted net assets . 28 1:3 29 Permanently restricted net assets. 29 If . Organizations that do not follow SFAS 117 (A36 958), check here and if; 3 complete lines 30 through 34. a - a .3 30 Capital stock or trust prinCIpal, or current funds . . 39 31 Paid- -in or capital surplus, or land, bUIIding, or eqUIpment fund 31 32 Retained earnings, endowment, accumulated income, or other funds . Total net assets or fund balances3I4 Total liabilities and net assets/fund balances . REV 05I20119 PRO Form 990 (2013) Form 996 (2013) Part XI Reconciliation of Net Assets Page 12 Check if Schedule 0 contains a response or note to any line in this Part Total revenue (must equal Part column (A), line 12Total expenses (must equal Part IX, column (A) line 25) 2 620, 694 . 3 Revenue less expenses. Subtract line 2 from line Net assets or fund balances at beginning of year (must equal Part X, line 33, column 4 98 532 5 Net unrealized gains (losses) on Investments 5 6 Donated sewices and use of 6 7 Investment expenses . 7 8 Prior period adjustments . . . 8 9 Other changes In net assets or fund balances (explain In Schedule 9 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part line 33, column . . . . . 10 194,301. Financial Statements and Reporting Check if Schedule 0 contains a response or note to any line In this Part XII . . . Yes No 1 Accounting method used to prepare the Form 990. Cash Accrual Other If the organization changed Its method of accounting from a prior year or checked ?Other," explain In Schedule 0. 0 2a Were the organization?s fInanCIal statements complied or reVIewed by an independent accountant? . 2a If "Yes," check a box below to indicate whether the finanCIai statements for the year were compiled or nu reVIewed on a separate basis, consolidated or both: 9 Separate baSlS Consolidated ba5is Both consolidated and separate Were the organization? 5 Manual statements audited by an independent accountant? . . 2b If "Yes, check a box below to indicate whether the ?nancial statements for the year were audited on a a a separate ba5is. consolidated ba3is, or both: a Separate Consolidated baSlS Both consolidated and separate baSlS 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? 2c If the organization changed either Its over5ight process or selection process during the tax year, explain In Schedule 0. g, a 3a 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?Yes, did the organization undergo the required audIt or audits? If the organization did not undergo the reqUIred audit or audits, explain why In Schedule 0 and describe any steps taken to undergo such audits. 3b REV 05120? 9 PRO Form 990 (2018) SCHEDULE A Public Charity Status and Public (Form 990 or 990-EZ) Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. Department of the Treasury Attach to Form 990 or Form 990-EZ. - Open to Public Internal Revenue Semce Go to for instructions and the latest information. Inspection Name of the organization Employer identification number GRASSROOT INSTITUTE OF HAWAII, INC 99- 0354937 Reason for Public Charity Status (All organizations must complete this part.) )See Instructions. The organization is not a private foundation because It Is: (For lines 1 through 12 check only one box.) 1 A church convention of churches. or assomation of churches described in section 2 A school described In section (Attach Schedule (Form 990 or 990- 3 A hospital or a cooperative hospital serVIce organization described In section 4 A medical research organization operated In With a hospital described In section Enter the hospital? 5 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 (Complete Part II.) 6 A federal, state, or local government or governmental unit described In section 7 An organization that normally receives a substantial part of Its support from a governmental unit or from the general public described in section (Complete Part II.) 8 A community trust described In section (Complete Part II.) 9 An agricultural research organization described In section 170(b)(1)(A)(ix) operated In conjunction With a land-grant college or university or a non-land-grant college of agriculture (see Instructions). Enter the name, city, and state of the college or univerSIty: 10 An receipts from actiVIties related to Its exempt functions? s?ubject to certain exceptions, and (2) no more than 331/a% of Its support from gross Investment Income and unrelated busmess taxable' Income (less section 511 tax) from busmesses achIred by the organization after June 30, 1975. See section 509(a)(2). (Complete Part 11 An organization organized and operated excluswely to test for public safety. See section 509(a)(4). 12 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box In lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 129. a Type I. A supporting organization operated, superwsed, 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. Type II. A supporting organization superVIsed or controlled In connection With Its supported organization(s), by havmg 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. Type 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. Type 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. Check this box If the organization received a written determination from the IRS that It is a Type I, Type II, Type functionally Integrated, or Type non- functionally Integrated supporting organization. Enter the number of supported organizations . . . . . . . . . . . . . . . . . Prowde the followmg Information about the supported ciganization(s). (I) Name of supported organization (Ii) EIN Type of organization (iv) Is the organization Amount of monetary (vi) Amount of (described on lines 1-10 ?Sted in your 90?!me support (see other support (see above (see document? instructions) Instructions) Yes No (A) (B) (C) (D) (E) Total For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. BAA Schedule A (Form 990 or 990-EZ) 2018 REV 10I24I18 PRO Schedule A (Form 990 or 990-EZ) 201 a Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) I (Complete only if you cked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify der Part If the organization ails to qualify under the tests listed below, please complete Part ?ags 2 Section A. Public Support Calendar year (or fiscal year beginning in?? 2014 2015 2016 2017 2018 Total 1 Gifts, grants contributions, and\ membership fees received. (Do not include any ?unusual grants") . . . 2 Tax revenues levred for the organization?s benefit and either paid to or expended on its behalf . . . 3 The value of sewices or fac?ities furnished by a governmental unit to the organization Without charge . 4 Total. Add lines 1 through 3 . 5 The portion of total contributions by 0 each person (other than governmental unit or publicly supported organization) included on . line 1 that exceeds 2% of the amount . 9 shown on line 11, column . .. 6 Public support. Subtract line 5 from line 4 1 a Section B. Total Support Calendar year (or fiscal year beginning in) 2014 2015, 2016 2017 2018 Total 7 Amounts from line 4 . . 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from Similar sources . . . . . . 9 Net income from unrelated activities, whether or not the busmess 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'i'through10 w" 12 Gross receipts from related actIVIties, etc. (see instructionsFirst five years. If the Form 990 is for the organization? 5 first, second. third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here . . . . . . . . . . . . . . . . . Section C. Computation of Public Support/Percentage 14 Public support percentage for 2018 (line 6" column (1) dwided by line 11, column (Public support percentage from 2017 ScheduleA Part II, line 14 . . . 15 16a 331/a% support test? 2018. If the organization did not check the box on line 13, and line 14 i 331/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization . . . . . . . 331/a% support test? 2017. If the/[organization did not check a box on line 13 or 16a, and line 15 is 331/3% or more, check this box and stop here. The organization qualifies asapublicly supported organization . . . . . . . . . [3 17a test?2018. If the organization did not check a box on line 13, 16 or 16b, and line 14 is 10% or more, and if the organization meets the ?facts-and-crrcumstances" test, check this box an stop here. Explain in Part VI how the organization meets the ?facts-and-crrcumstances" test. The organization qualifies :s\a publicly supported organization . . . . . . . . . nces test?2017. If the organization did not check a box on line 13, 16a, 16b. or 17a, and line 15 is 10% or more, any/a 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 organizatio . . . . . . . 18 Private foundation. fthe organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see Schedule A (Form\990 or 990-EZ) 2018 REV 10I24I1B PRO Schedule'A (Form 990 or 990-EZ) 2018 Support Schedule for Organizations Described in Section 509(a)(2) Page 3 (Complete only if you checked the box on line 10 of Part 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 Calendar year (or fiscal year beginning in) 1 2 8 Gifts, grants, contributions, and membership fees received. (00 not include any ?unusual grants.") Gross receipts from admissions, merchandise sold or serVices performed, or faCIiities furnished in any actiwty that is related to the organization?s tax-exempt purpose . Gross receipts from activities that are not an unrelated trade or busrness under section 513 Tax revenues levred for the organization's benefit and either paid to or expended on Its behalf The value of serwces or faCIlities furnished by a governmental unit to the organization without charge . Total. Add lines 1 through 5 . 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% of the amount on line 13 for the year Add lines 7a and 7b Public support. (Subtract line To from . 2014 2015 2016 2017 2018 Total 360, 762 . 439, 251 . 507, 370. 676,723. 712,235. 2,696, 341. 17,264. 23, 891. 9,940. 8,151. 2,968. 62,214. 378, 026. 463, 142. 517, 310. 684, 874 . 715,203. 2,758,555. 70, 652. 68, 635. 115, 663. 149, 854. 113, 180. 517, 984 . 179, 370. 21,035. 11, 000. 106, 568 . 207,745. 525,718. 250, 022 . 89, 670. 256, 422 . 1,043,702. .1 9 II a 4! at: 126, 663320, 925. .i 0 1,714,853. Section B. Total Support Calendar year (or fiscal year beginning inAmounts from line 6 . . Gross income from interest, dwidends, payments received on securities loans, rents, royalties, and income from similar sources . Unrelated busrness taxable income (less section 511 taxes) from busmesses acqwred after June 30,1975 . Add lines 10a and 10b Net income from unrelated busrness activnies not included in line 10b, whether or not the busmess is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI. . Total support. (Add lines 9,100,11, and 12.) 2014 2015 2016 2017 2018 Total 378,026. 463, 142. 517, 310. 684, 874 . 715,203. 2,758,555. 1,929. 42. 30. 1,261. 3,262. 1, 929. 42. 30. 1,261. 3,262. 379, 955. 463,184. 517,310. 684,904. 716, 464. 2, 761, 817. First five years. If the Form 990 is for the organization' first second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here Section C. Computation of Public Support Percentage 15 Public support percentage for 2018 (line 8, column divided by line 13, column (0) 15 62 . 09 16 Public support percentage from 2017 Schedule A, Part Ill, line Section D. Computation of investment Income Percentage 17 Investment income percentage for 2018 (line 10c, column dwided by line 13, column (0) . 17 12 18 Investment income percentage from 2017 ScheduleA, Part line 17.18 0 19a 33?ra% support tests?201B. If the organization did not check the box on line 14, and line 15 is more than 331/a%, and line 17 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization 33?ra% support tests?2017. 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 check this box and stop here. The organization qualifies as a publicly supported organization Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions REV 10124I1B PRO Schedule A (Form 990 or 990-EZ) 2018 20 Schedule?A (Form 990 or 990-EZ) 2018 Supporting Organizations Page 4 (Complete only if you checked 3 box in line 12 on Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations the organization's supported organizations listed by name in the organization's governing documents? if describe in Part VI how the supported organizations are deSignated. If de3ignated by class or purpose, describe the designation. lf 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 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 if ?Yes," answer and (0) 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 excluswely 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 12a or 12b in Part l, answer and 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 superwsed 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 if "Yes,? explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used excluswely for section 170(c)(2)(B) purposes. Did the organization add, substitute, or remove any supported organizations during the tax year? if ?Yes," answer and (0) below (if applicable). Also, prowde detail in Part VI, including the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; the authority under the organization ?5 organizing document authorizmg such action; and (iv) how the action was accomplished (such as by amendment to the organizmg document). Type or Type II only. Was any added or substituted supported organization part of a class already de3ignated in the organization's organizmg document? Substitutions only. Was the substitution the result of an event beyond the organization's control? Did the organization prowde support (whether in the form of grants or the prowsmn of sewices or facilities) to anyone other than its supported organizations, (ii) indiwduals that are part of the charitable class benefited by one or more of its supported organizations, or other supporting organizations that also support or benefit one or more of the filing organization?s supported organizations? If ?Yes, prowde detail in Part Vi. Did the organization provide a grant, loan, compensation, or other Similar payment to a substantial contributor (as defined in section a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If "Yes, complete Part of Schedule (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 of Schedule (Form 990 or 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 if ?Yes, prowde detail in Part Vi. 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 VI. Was the organization subject to the excess busmess holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type non-functionally integrated supporting organizations)? If ?Yes, answer 10b below. Did the organization have any excess busnness holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) Yes No 5a 5b 5c 10a 10b Schedule A (Form 990 or 990-EZ) 2018 REV 10l24/18 PRO Schedule A (Form 990 or 990-52) 2018 Supporting Organizations (continued) 11 Page 5 Has the organization accepted a gift or contribution from any of the followmg persons? a A person who directly or indirectly controls, either alone or together With persons described in and below, the governing body of a supported organization? A family member of a person described in above? A 35% controlled entity of a person described in or above? If ?Yes" to a, b, or c, provide detail in Part VI. Yes No 11a 11b 11c Section B. Type I Supporting Organizations 1 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? If ?No, describe in Part Vi how the supported organization(s) effectively operated, supervised, or controlled the organization '5 actiwties. If the organization had more than one supported organization, describe how the powers to appomt 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. Yes No Section C. Type II Supporting_OLg?nizations 1 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)? it "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). No Section D. All Type Supporting Organizations 1 Did the organization prowde to each of its supported organizations, by the last day of the fifth month of the organization's tax year, a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and cepies of the organization?s governing documents in effect on the date of notification, to the extent not preVIously prowded? Were any of the organization's officers, directors, or trustees either appomted or elected by the supported organization(s) or (ii) servmg on the governing body of a supported organization? If explain in Part VI how the organization maintained a close and continuous working relationship With the supported organization(s). By reason of the relationship described in (2), did the organization?s supported organizations have a Significant mice in the organization's investment policies and in directing the use of the organization?s income or assets at all times during the tax year? if "Yes, describe in Part the role the organization '3 supported organizations played in this regard. No Section E. Type Functionally Integrated Supporting Organizations Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions) 1 2 a CI The organization satisfied the Actiwties 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 and below. a 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 responsive? if "Yes," then in Part VI identify those supported organizations and explain how these actiwties directly furthered their exempt purposes, how the organization was responswe to those supported organizations, and how the organization determined that these actiwties constituted substantially all of its actiwties. Did the actiwties described in 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 the reasons for the organization?s pOSition that its supported organization(s) would have engaged in these activities but for the organization?s involvement. 3 Parent of Supported Organizations. Answer and below. 3 Did the organization have the power to regularly appomt or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI. Did the organization exerCIse a substantial degree of direction over the poIiCIes, programs, and actIVIties of each of its supported organizations? If ?Yes, describe in Part the role played by the organization in this regard. Yes filo in co? 3a in 3b Schedule A (Form 990 or 990-EZ) 2018 REV 10i?24l18 PRO Schedule'A (Form 990 or 990-EZ) 2018 Page 6 Type Non-Functionally Integrated 509(a)(3) Supporting Organizations 1 Cl Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type non-functionally integrated supporting organizations must complete Sections A through E. Section A?Adjusted Net Income (A) Prior Year (B) Current Year (optional) 1 Net short-term capital gain 2 Recoveries of prior-year distributions 3 Other gross income (see instructions) 4 Add lines 1 through 3. 5 DepreCIation and depletion Ulh?dM-? 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) .4 8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4) Section B?Minimum Asset Amount (A) Prior Year (B) Current Year (optional) 1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1. 0' ?b a Average value of securities 1a Average cash balances 1b Fair market value of other non-exempt-use assets 1c Total (add lines 1a, 1b, and 1c) 1d Discount claimed for blockage or other factors (explain in detail in Part VI): 2 Acquisition indebtedness applicable to non-exempt-use assets 3 Subtract line 2 from line 1d. 4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 5 Net value of non-exempt-use assets (subtract line 4 from line 3) 6 Multiply line 5 by .035. 7 Recoveries of prior-year distributions 8 Minimum Asset Amount (add line 7 to line 6) Section C?Distributable Amount Current Year 1 Adjusted net income for prior year (from Section A, line 8, Column A) 2 Enter 85% of line 1. 3 Minimum asset amount for prior year (from Section B, line 8, Column A) 4 Enter greater of line 2 or line 3. 5 Income tax imposed in prior year 6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions). 6 7 Check here if the current year is the organization's first as a non-functionally integrated Type supporting organization (see instructions). REV 10I24I18 PRO Schedule A (Form 990 or 990-EZ) 2018 Schedule'A (Form 990 or 990-EZ) 2018 Type ill Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Section Distributions Page 7 Current Year 1 (0 Amounts paid to supported organizations to accomplish exempt purposes Amounts paid to perform actiVity that directly furthers exempt purposes of supported organizations, in excess of income from actiwty Administrative expenses paid to accomplish exempt purposes of supported organizations Amounts paid to achIre exempt-use assets Qualified set-aside amounts (prior IRS approval requwed) 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 responswe (prowde details in Part VI). See instructions. Distributable amount for 2018 from Section C, line 6 Line 8 amount divided by line 9 amount Section E?Distribution Allocations (see instructions) (0 Excess Distributions (ii) Underdistributions Pre-2018 Distributable Amount for 2018 Distributable amount for 2018 from Section C, line 6 Underdistributions, if any, for years prior to 2018 (reasonable cause reqUired?explain in Part VI). See instructions. Excess distributions carryover, if any, to 2018 From 2013 From 2014 From 2015 From 2016 From 2017 Total of lines 33 through Applied to underdistributions of prior years Applied to 2018 distributable amount Carryover from 2013 not applied (see instructions) Remainder. Subtract lines 39, 3h, and 3i from St. Distributions for 2018 from Section D, line 7: Applied to underdistributions of prior years Applied to 2018 distributable amount Remainder. Subtract lines 4a and 4b from 4. Remaining underdistributions for years prior to 2018, if any. Subtract lines 39 and 43 from line 2. For result greater than zero, explain in Part VI. See instructions. Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. For result greater than zero, explain in Part VI. See instructions. Excess distributions carryover to 2019. Add lines 3] and 4c. Breakdown of line Excess from 2014 Excess from 2015 . Excess from 2016 . Excess from 2017 Excess from 2018 . ?0 REV 1004/18 PRO Schedule A (Form 990 or 990-EZ) 2018 Schedule A (Form 990 or 2018 Page 8 Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part line 12; Part IV, Section A, lines 9a, 9b, 90, 11a, 11b, and 110; 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.) REV 10I24I18 PRO Schedule A (Form 990 or 990-52) 2018 SCHEDULE OMB No 1545-0047 Supplemental Financial Statements (Form 990) Complete if the organization answered ?Yes" on Form 990, Part IV, line 6, 7,8, or 12b. Department of the Treasury Attach to Form 990. Open to Public Internal Revenue Sewice Go to for instructions and the latest information. Inspection. Name of the organization Employer identi?cation number GRASSROOT INSTITUTE OF HAWAII, INC 99-0354 937 Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered ?Yes? on Form 990, Part IV, line 6. Donor advrsed funds Funds and other accounts Total number at end of year. Aggregate value of contributions to (during year) Aggregate value of grants from (during year) Aggregate value at end of year . Did the organization inform all donors and donor adVisors in writing that the assets held in donor advised funds are the organization? 3 property, subject to the organization' 5 exclusrve legal controlDid the organization inform all grantees, donors, and donor adVIsors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor. or for any other purpose conferring impermISSIble private benefitConservation Easements. Complete if the organization answered ?Yes" on Form 990, Part IV, line 7. 1 Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use recreation or education) Preservation of a historically important land area Protection of natural habitat Preservation of a certified historic structure Preservation of open space 2 Complete lines 23 through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. - Held at the End of the Tax Year a Total number of conservation easements . . . . . . . . . . . . . . . . . 2a Total acreage restricted by conservation easementsNumber of conservation easements on a certified historic structure included in . . . . 2c Number of conservation easements included in achIred after 7/25/06, and not on a historic structure listed in the National Register . . . . 2d 3 Number of conservation easements modified transferred, released or terminated by the organization during the tax year 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of Violations, and enforcement of the conservation easements it holdsStaff and volunteer hours devoted to monitoring, inspecting, handling of Violations, and enforcmg conservation easements during the year i 7 Amount of expenses incurred in monitoring, inspecting, handling of Violations, and conservation easements during the year 8 Does-eachconse-r-vation easement reported on line 2(d) above satisfy the reqUIrements of section and section . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 9 In Part describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization?s financial statements that describes the organization?s accounting for conservation easements. Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered ?Yes" on Form 990, Part IV, line 8. 1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other Similar assets held for public exhibition, education, or research in furtherance of public serVice, provide, in Part the text of the footnote to its financial statements that describes these items. If the organization elected, as permitted under SFAS 116 (A80 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other Similar assets held for public exhibition, education, or research in furtherance of public servrce, prowde the following amounts relating to these items RevenueincludedonFoerQO PartVl ,line1 . . . . . . . . . . . . . . . . (ii) Assets included in Form 990, Part . . . . . . . 2 If the organization received or held works of art, historical trea3ures, or other Similar assets for finanCial gain, prowde the followmg amounts required to be reported under SFAS 116 (A80 958) relating to these items. 3 Revenue included on Form 990, Part line Assets included in Form 990, Part . . . . . . . . . . . . . . . . . . . . For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule 0 (Form 990) 2018 BAA REV Schedule (Form 990) 2018 Page 2 Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 3 Usmg the organization's acqursmon, accessmn, and other records, check any of the followmg that are a Significant use of its collection items (check all that apply): a Public exhibition Loan or exchange programs Scholarly research Other Preservation for future generations 4 Prowde a description of the organization?s collections and explain how they further the organization?s exempt purpose in Part 5 During the year, did the organization what or receive donations of art, historical treasures, or other Similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection? . . Yes No Escrow and Custodial Arrangements. Complete if the organization answered ?Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. 1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not . If ?Yes, explain the arrangement in Part and complete the followmg table: Amount Beginning balance . . . . . . . . . . . . . . . . . . . . . . 1c Additions during the year . . . . . . . . . . . . . . . . . . . Distributions during the year . . . . . . . . . . . . . . . . . . 1e Ending balance . . . 1f 23 Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? El Yes No If ?Yes,? explain the arrangement in Part Check here if the explanation has been provrded on Part . . . . I Part Endowment Funds. Complete if the organization answered ?Yes" on Form 990, Part IV, line 10. Current year Prior year to) Two years back Three years back Four years back 1a Beginning of year balance Contributions . Net investment earnings, gains, and losses . . . Grants or scholarships Other expenditures for faculties and programs . Administrative expenses . 9 End of year balance . 2 Provide the estimated percentage of the current year end balance (line 19, column held as: a Board designated or quaSI- -endowment Permanent endowment Temporarily restricted endowment The percentages on lines 2a, 2b, and 2c should equal 100%. 3a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: unrelated organizations . (ii) related organizations . . 4b If ?Yes" on line 3a(Ii), are the related organizations listed as reqwred on Schedule Ft? . Describe in Part the intended uses of the organization' 3 endowment funds Land, Buildings, and Equipment. Complete if the organization answered ?Yes? on Form 990, Part IV, line 11a. See Form 990, Part X, line 10. Description of property Cost or other ba5is Castor other Accumulated Book value (investment) (other) depreCIation 1a O. 0. Buildings . . Leasehold improvements . Equment . . . . . . . . . 0. 4,541. 3,961. 580. Other Total. Add lines 1a through 1e. (Column must equal Form 990, PartX, columriB), line 10c .) . . 580. REV 11?12?13 PRO Schedule 0 (Form 990) 2018 BAA Schedule (Form 990) 2018 Page 3 Investments?Other Securities. Complete if the organization answered ?Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12. Description of security or category Book value Method of valuation (including name of security) Cost or end-of-year market value (1) Financral derivatives . (2) Closely-held eqUity interests . (3) Other Total. {Column must equal Form 990, Part X, col line 12) Part Investments?Program Related. Complete if the organization answered ?Yes? on Form 990, Part IV, line 110. See Form 990, Part X, line 13. Description of investment Book value Method of valuation Cost or end-of-year market value Total. (Column must equal Form 990, Part X, col (B) line 13.) Other Assets. Complete if the organization answered ?Yes? on Form 990, Part IV, line 11d. See Form 990, Part X, line 15. Description Book value l1) (2) (3) (4) (5) (6) (7) (Bi (9) Total. (Column must equal Form 990, Part X, col. (8) line 15Other Liabilities. Complete if the organization answered ?Yes? on Form 990, Part IV, line He or 11f. See Form 990, Part X, line 25. . Description of liability (1) Federal income taxes (2) (3) (4) (5) (5) (7) (3) (9) Total. {Column must equal Form 990, Part X, col. (B) line 25 2. Liability for uncertain tax posrtions. In Part prowde the text of the footnote to the organization?s finanCIal statements that reports the organization's liability for uncertain tax posmons under FIN 48 (A80 740). Check here if the text of the footnote has been provrded in Part Schedule (Form 990) 2018 Book value Schedule 15 (Form 990) 2013 Page 4 Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete If the organization answered ?Yes? on Form 990, Part IV, lIne 12a. 1 Total revenue, gems, and other support per audited finanCIal statements . . . . . . . . . 1 2 Amounts Included on line 1 but not on Form 990, Part line 12: Net unrealIzed gaIns (losses) on investments . . . . . . . . . 2a Donated serVIces and use RecoverIes of mm year grants . . . . . . . . . . . . . . 2c Other In Part . . . . . . . . . . . . . . . 2d Add lines 2a through 2d . 3 Subtract line 2e from Amounts Included on Form 990, Part Ilne 12 ,but not on Me 1: (90.069) a Investment expenses not Included on Form 990, Part line 7b . . 4a Other (Describe in Part . . . . . . . . . . . . . . . 4b - Add lines Total revenue. Add lInes 3 and 4c. (T must equaI Form 990, PartIReconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete If the organizatlon answered "Yes" on Form 990, Part IV, line 12a. 1 Total expenses and losses per audIted fInanCIal statements . . . . . . . . . . . . . 1 Amounts included on line 1 but not on Form 990, Part IX, Me 25: Donated serVIces and use of facilltIes . . . . . . . . . . . 2a Prior year adjustments . . . . . . . . . . . . . . . . 2b Other losses . . . . . . . . . . . . . . . . . 2c Other (Describe In Part . . . . . . . . . . . . . . 2d Add lInes 2a through 2d . 3 Subtract line 2e from Ms 1 . . . 4 Amounts Included on Form 990, Part IX, line 25, but not on lIne 1: a Investment expenses not Included on Form 990, Part line 7b . . 4a Other (Describe In Part . . . . . . . . . . . . . . . 4b AddlInes4aand4b . . . . . . . . . 4c 5 Total expenses. Add [Ines 3 and 4c. (This must equal Form 990, PerSupplemental InformatIon. Prowde the descrIptIons requ1red for Part II, lInes 3, 5, and 9; Part IInes 1a and 4; Part IV, lInes 1b and 2b, Part V, Me 4; Part X, Me 2, Part XI, IInes 2d and 4b; and Part XII, lines 2d and 4b. Also complete thIs part to prowde any addItIonaI InformatIon. BAA REV 11I12I18 PRO Schedule (Form 990) 2018 Schedule 0 (Form 99b) 2013 Page 5 Supplemental Information (continued) Schedule (Form 990) 2018 SCHEDULE Noncash Contributions OMB No 1545-0047 (Form 990) >Complete if the organizations answered ?Yes" on Form 990, Part IV, lines 29 or 30. Department of the Treasury >Attach to Form 990' Open to, PUb'ic Internal Revenue Seerce Go to for the latest information. . Inspection Name of the organization Employer Identi?cation number GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Types of Property IO) if Number of origtributions or Noncash conmbumn Method of((cjl)etermining applicable Items contributed amounts reported on noncash contribution amounts orm 990, Part line 19 1 Art?Works of art 2 Art?Historical treasures . 3 Ait?Fractional interests . 4 Books and publications . . . .. ?5 *n 5 Clothing and household if a 9 .v {aw-?u 6 Cars and other vehicles 7 Boats and planes 8 Intellectual property 9 Securities?Publicly traded . 10 Securities?Closely held stock . 11 Securities-Partnership, LLC, or trust interests . 1 2 Securities Miscellaneous 13 Qualified conservation contribution?Historic structures . . 14 Qualified conservation contribution?Other 15 Real estate?FleSIdential . 16 Real estate?Commercial 17 Real estate?Other . 18 Collectibles 19 Food inventory . . . 20 Drugs and medical supplies . 21 TaXIdermy . 22 Historical artifacts . 23 Scientific speCImens 24 Archeological artifacts 25 Other 26 Other 27 Other 28 Otherb 29 Number of Forms 8283 received by the organization during the tax year for contributions for which the organization completed Form 8283, Part IV, Donee Acknowledgement . . . . . 29 Yes No 30a During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution. and which isn't reqwred [2 1: to be used for exempt purposes for the entire holding period? 303 If ?Yes," describe the arrangement in Part H. .9 31 Does the organization have a gift acceptance policy that reqUIres the review of any nonstandard l? L- 32a Does the organization hire or use third parties or related organizations to process, or sell noncash contributions? . 323 If ?Yes," describe in Part II. an 33 If the organization didn't report an amount in column (0) for a type of property for which column is checked, it 9 i describe in Part II. a For Paperwork Reduction Act Notice. see the Instructions for Form 990. BAA REV 10i'24l18 PRO Schedule (Form 990) 2018 Schedule Ni (Form 990) 2018 Page 2 Supplemental Information. Provide the Information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information. REV 10124115 PRO Schedule (Form 990) 2018 OMB No 1545-0047 Open to Public SCHEDULE 0 Supplemental Information to Form 990 or (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 Sennce Go to for the latest information. Inspection Name of the organization Employer identrficatlon number GRASSROOT INSTITUTE OF HAWAIIJ INC 99-0354937 Pt VI, Line 19: UPON REQUEST Total: $5,456 Program serv1ces: $3,000 Descriptlon: OTHER 5 0 For Paperwork Reduction Act Notice, see the Instructions for Form 990 or B?i No 51056K Schedule 0 (Form 990 or 990-52) (2018) REV 10124I18 PRO