(I. I 0MB 1545-0047 Form 990 0 Return of Organization Exempt From Income Tax 201 4 Under section 501 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) m" I I Do not enter social security numbers on this form as it may be made public. Open to Public .3558. Information about Form 990 and its instructions is at Inspection A For the 2014 calendar year, or tax year beginning 2014, and ending 8 Check if applicable Name of organization GRAS SROOT INST ITUTE OF HAWAI I I INC Employer Identifiia?on number Address change Domg business Name change Number and street (or 0 box if mail Is not delivered to street address) Roomlsulte Telephone number Initialretum 335 MERCHANT ST 3377 (808) 591?9193 Final retumftermlnaled City or town. state or province. country, and ZIP or foreign postal code Amendedretum Honolulu HI 96801 Grossreceipts 379, 955. Application pending Name and address of of?cer H(a) Is this a group retum for subordinates? Hy? No I Nib) KELI I AKINA 335 MERCHANT ST #3377 HONOLULU Tax-exempt status I I 501(c) ansen no) I I4947(a)(1) or I527 Website: A H(c) Group exemptlon number Form of organization ?ICorporation I ITnist I I Assoaatlon I I Other IL Year of formation 2 I State of legal domraie HI I Part I I Summary 1 Brie?y describe the organization's mission or most signi?cant actiwties: 2.51]; 139933: oi .. .e to 2 Check this box the organization discontinued its operations or disposed of more than 25% of its net assets. ?5 3 Number of voting members of the governing body (Part VI. line 1a) 3 5 ?2 4 Number of independent voting members of the governing body (Part VI, line 1b) 4 4 5% 5 Total number of indivrduals employed in calendar year 2014 (Part V. line 2a) 5 6 Total number of volunteers (estlmate if necessary) 5 :1 7a Total unrelated busmess revenue from Part column (C), line 12Net unrelated business taxable income from Form 990-T, line .32} [$119k 7b 0 m" Prior Year Current Year 304,597. 360,762. - - NOV 2015 l? 9 Program seNice revenue (Part line 29) . . . 1.7Investment income (Part column (A), lines 3, 4, and I783 Other revenue (Part Vill, column (A), lines 5, 6d, 80, 90, 1?0c, . n-w- 12 Total revenue add lines 8 through 11 (must equal PartIVlil. lir'Grants and similar amounts paid (Part ix, column (A). lines 1-3) 14 Bene?ts paid to or for members (Part IX, column (A). line 4) a: 15 Salaries. other compensation. employee bene?ts (Part IX, column (A), lines 5-1016a Professional fundraismg fees (Part IX, column (A), line 11a) g- Total fundraismg expenses (Part IX. column (D), line 25) 0 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) 124 I 803 . 139, 773 . 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25Revenue less expenses Subtract line 18 from line Beginning of Current Year End of Year 35 20 Total assets (PartX. line 16) 8: 854. 24I 456. 21 Total liabilities (Part X. line 26Net assets or fund balances. Subtract line 21 from line 5?3. I Part II ISLgnature Block 3 Under penaibes of penury, I declare that I have examined this return. including awompanying schedules and statements. and to the best of my knowledge and belief, it is true. correct. and complete. Declaration of preparer (other than of?cer) is by!? all information of which preparer has any knowledge Signature oer Date L, Sign I Here Type or name and title. I Print/Type preparers name Prepare signature Date Check BI ,f PTIN Paid GERALD USHIJIMA, CPA 9946/2015 self-employed 901356124 Q: Preparer an's name GERALD Y. USHIJI 0 Use an'saddress 11 10 UNIVERSITY AVE STE 508 99?0230347 U3 HONOLULU HI 96826-1508 Phoneno. (808) 949-5588 May the IRS discuss this return with the preparer shown above? (see instructions) IXI Yes I BAA For Paperwork Reduction Act Notice. see the separate instructions. 05128114 Form 990 (2014) 10% Form 990 (2014) GRASSROOT OF HAWAI I INC 99?0 3 5 4 937 Page 2 f? Statement of Program Service Accomplishments . Check If Schedule 0 contains a response or note to any line in this Part 1 Brie?y describe the organlzation's mission: PUBLIC POLICY RESEARCH AND EDUCATION 2 Did the organization undertake any signi?cant program services during the year which were not listed on the prior Form 990 or 990.52? Yes No If 'Yes.? describe these new sen/Ices on Schedule 0. 3 Did the organization cease conducting, or make Signi?cant changes in how it conducts. any program services? Yes No If 'Yes.? describe these changes on Schedule 0. 4 Describe the organization's program service accomplishments for each of its three largest program servrces. 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 15:938. Including grants of 0, )(Revenue TRANSPARENCY PROGRAM - MULTIFACETED EFFORTES TO SHED LIGHT ON 4b (Code: (Expenses 80 573 Including grants of 0 (Revenue 0 @1935 1399(2)? 39121129 $999192 91.519 913E183. 91:1 93513912 23939. .03 .EEZLTX INFORMATIONAL MEETINGS, STUDIES AND OTHER ACTIVITIES 4c (Code: (Expenses 10! 574 . Including grants of 0 (Revenue 0 ACE .REE 91134: 333.52 EABEPL .I E1120. EEFEETLS. 913'. .TEE. 3.92.0. 1A3 5 ILL 511'; 2 WI ?031.. .5. r_ 9 All] 12 3991113; 9N. 1.le- 5113.5. 19.: QUEBEC. 41! Other program services. (Descnbe In Schedule 0.) (Expenses 4 6 8 07 Including grants of 0 (Revenue 0 4 Total program service expenses 153 8 92 . BAA TEEA0102 05/28/14 Form 990 (2014) Form 990 (2014) GRASSROOT INSTITUTE OF HAWAI I INC 99?03 54 93 7 Page 3 IPart lV lghecklist 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 A 1 2 Is the organization requ1red to complete Schedule B, Schedule of Contributors (see instructions)? 2 Did the organization engage in direct or indirect political campaign actiwties on behalf of or in opposition to candidates for public of?ce? If 'Yes, complete Schedule C, Part I 3 4 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 4 5 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 de?ned in Revenue Procedure 98-19? If ?Yes, ?complete Schedule C, Part 5 6 Did the organization maintain any donor adVIsed funds or any Similar funds or accounts for which donors have the to provrde adVice on the distribution or investment of amounts in such funds or accounts? If ?Yes, complete Schedule D, Part I 6 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment. histonc land areas, or historic structures? If 'Yes,'complete Schedule D, Part II 7 8 Did the organization maintain collections of works of art, historical treasures, or other Similar assets? If ?Yes, complete Schedule D, Part 8 9 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 or provide credit counseling. debt management, credit repair, or debt negotiation services? If 'Yes, complete Schedule D, Part IV 9 10 Did the organization. directly or through a related organization, hold assets in temporarily restricted endowments. permanent endowments. or quasr-endowments? If ?Yes, complete Schedule D, Part 10 1 1 If the organization?s answer to any of the followrng questions is 'Yes', then complete Schedule D. Parts VI, VII, IX, or as applicable. a Did the organization report an amount for land, bUiIdings and equrpment in Part X, line 10? If 'Yes, complete Schedule D, Part VI 11 a 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 11 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 11 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 11 Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes,? complete Schedule D, PartX 11 Did the organization's separate or consolidated ?nancial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If 'Yes, complete Schedule D, PartX 11 123 Did the organization obtain separate, independent audited ?nancial statements for the tax year? If ?Yes, 'complete Schedule D, Parts XI, and XII 12a Was the organization included in consolidated, independent audited ?nancial statements for the tax year? If 'Yes, 'and if the organization answered ?No? to line 128, then campleting Schedule D, Parts XI and XII is optional 12b 1 3 Is the organization a school described in section If 'Yes,?complete Schedule 13 14a Did 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, fundraising, business, investment, and program servrce activities outside the United States. or aggregate foreign investments valued at $100,000 or more? If ?Yes, 'complete Schedule F, Parts I and IV 14b 1 5 Did the organization report on Part IX. column (A), line 3. more than $5,000 of grants or other assustance to or for any foreign organization? If 'Yes, complete Schedule F, Parts II and IV 15 16 Did the organization report on Part IX, column (A). line 3. more than $5,000 of aggregate grants or other assmtance to or for foreign indivrduals? If 'Yes,?complete Schedule F, Parts and IV 15 17 Did the anization report a total of more than $15,000 of expenses for professwnal fundraisrng servrces on Part IX, column (A lines 6 and 11a? If ?Yes, 'complete Schedule G, Part I (see instructions) 17 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part lines 10 and 83? If 'Yes, 'complete Schedule G, Part II 18 19 Did 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 Did the organization operate one or more hospital facilities? If 'Yes,?complete Schedule 20 If ?Yes' to line 203, did the organization attach a copy of its audited ?nancial statements to this return? 20 BAA 05/28/14 Form 990 (2014) Form 990 (2014) GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Page4 [Part IV [Checklist of Required Schedules (continued) . Yes No 21 . 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 I, Parts land ll 21 22 Did the organization report more than $5.000 of grants or other assistance to or for domestic individuals on Part IX, column (A). line 2? If 'Yes,? complete Schedule I, Parts I and Ill 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 of?cers, directors. trustees. key employees. and highest compensated employees? If ?Yes. complete Schedule 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 If ?No, '90 to line 25a 24: Did the organization invest any proceeds of tax-exempt 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 25a Section 501(c)(3). 501(c)(4). and 501(c)(29) organizations. Did the organization en age in an excess bene?t transaction With a disquali?ed person during the year? If 'Yes,? complete Schedule L. art I 25a Is the organization aware that it engaged in an excess bene?t transaction With a disquali?ed person in a pnor year. and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-52? If 'Yes, complete Schedule L, Partl 25b 26 Did the anizatjon report any amount on Part X, line 5. 6. or 22 for receivables from or payables to any current or former 0 cars. directors. trustees. key employees. highest compensated employees, or disquali?ed persons? If 'Yes?. complete Schedule L, Part II 26 27 Did the organization provide a grant or other 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 27 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L. Part IV instructions for applicable tiling thresholds, conditions. and exceptions): a A current or former of?cer. director. trustee. or key employee? If 'Yes, 'oomplete Schedule L, Part IV 28a A family member of a current or fon?ner of?cer, director. trustee. or key employee? If 'Yes, complete Schedule L, Part IV 28b An entity of which a current or former of?cer. director. trustee. or key employee (or a family member thereof) was an of?cer. 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? lf ?Yes.?complete Schedule 29 30 Did the organization receive contributions of art. historical treasures. or other similar assets. or quali?ed conservation contributions? If 'Yes.?oomplete Schedule 30 31 Did the organization liqwdate. terrninate. or dissolve and cease operations? If 'Yes, complete Schedule N, Part I 31 32 Did the organization sell. exchange. dispose of, or transfer more than 25% of its net assets? If ?Yes,? complete Schedule N. Part II 32 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? lf 'Yes,?complete Schedule R, Partl 33 34 Was the organization related to any tax-exempt or taxable entity? If ?Yes,?complete Schedule R, Part ll, or IV. and Part V, line 1 34 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 353 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 Schedu R, Part V, line 2 35b 36 Sectlon 501 organizations. Did the organization make any transfers to an exempt non-chantable related organization? ?Yes,? complete Schedule R. Part V, line 2 36 37 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 37 38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI. lines 11b and 19? Note. All Form 990 ?lers are required to complete Schedule 0 38 BAA Form 990 (2014) TEEAD104 05/28/14 Forrn990t2014) GRASSROOT INSTITUTE or HAWAII, INC 99?0354937 Pages IPart lStatements Regarding Other IRS Filings and Tax Compliance Check if Schedule 0 contains a response or note to any Irne in this Part Yes No 1 a Enter the number reported In Box 3 of Form 1096. Enter -0- If not applicable 1 a 0 Enter the number of Forms W-ZG included in line 1a. Enter -0- if not applicable 1 Did the anizatron comply with backup withholding rules for reportable payments to vendors and reportable gaming to prize wrnners? 1 2 a Enter the number of employees reported on Form Transmittal of Wage and Tax State- ments. ?led for the calendar year ending with or within the year covered by return 2 a If at least one rs reported on lrne 23, did the organrzation ?le all required federal employment tax returns? 2 Note. If the sum of lrnes 1a and 2a is greater than 250. you may be requrred to e??le (see Instructions) 3 3 Did the organization have unrelated busrness gross income of $1,000 or more dunng the year? 3 a If 'Yes? has it ?led a Form 990-T for this year? If 'No? to line 3b, provrde an explanation ln Schedule 0 3 4a At any time during the calendar year, did the organizatron have an interest in, or a srgnature or other authority over, a ?nancral account rn a foreign country (such as a bank account. secunties account. or other ?nancial account)? 4 a If 'Yes,? enter the name of the forergn country See instructions for ?lrng requrrements for Form 114, Report of Foreign Bank and Financral Accounts. (FBAR) 5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? 5 a any taxable party notify the organrzation that It was or is a party to a tax shelter transaction? 5 If 'Yes.? to line 5a or 5b, did the organrzation ?le Form 5 6 a Does the organrzatron have annual gross receipts that are normally greater than $100,000. and the organrzatron any contributions that were not tax as charitable contributions? 6 a If 'Yes,? the organrzation include with every an express statement that such contributions or gifts were not tax deductible? 5 7 Organizations that may receive deductible contributions under section 170(c). a the organrzatron receive a payment in excess of $75 made partly as a contnbutron and partly for goods and services provrded to the payer? 7 a If 'Yes,? the organizatron notify the donor of the value of the goods or servrces provided? 7 Did the organizatron sell, exchange, or dispose of tangible personal property for which It was requrred to ?le Form 8282? 7 If 'Yes,? Indicate the number of Forms 8282 ?led during the year I 7 dl Did the organizatron recerve any funds. drrec?y or indirectly, to pay premiums on a personal bene?t contract? 7 Did the organization, during the year, pay premiums. directly or Indrrec?dy. on a personal bene?t contract? 7f If the organrzatron received a contribution of qualr?ed intellectual property. the organrzatron ?le Form 8899 as requrred? 7 If the organizatron received a contribution of cars, boats. airplanes. or other vehicles, the organrzation ?le a Form 1098-0? 7 3 Sponsoring organizations maintaining donor advised funds. Did a donor advrsed fund maintarned by the sponsoring organrzatron have excess business holdings at any trme dunng the year? 8 9 Sponsoring organizations maintaining donor advised funds. 3 Did the sponsonng organrzatron make any taxable under section 4966? 9 a the sponsonng organrzatron make a to a donor. donor advrsor, or related person? 9 10 Section 501(c)(7) organizations. Enter' a Initratron fees and capital contnbutions included on Part line 12 10a Gross receipts, Included on Form 990, Part Irne 12, for pubIrc use of club facilrtres 10b 11 Section 501 organizations. Enter: a Gross Income from members or shareholders 11 a Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or recerved from them.) 11 12 a Section 4947(a)(1) non-exempt charitable trusts. Is the organization ?lrng Form 990 In lieu of Form 1041? 12 a If ?Yes.? enter the amount of tax-exempt Interest recerved or accrued during the year I 12 bl 13 Section 501(c)(29) quali?ed nonpro?t health insurance issuers. a Is the organizatron licensed to rssue quali?ed health plans in more than one state? 13a Note. See the instructions for information the organization must report on Schedule 0. Enter the amount of reserves the organization is requrred to malntaln by the states In the organrzation Is licensed to issue quali?ed health plans 13b Enter the amount of reserves on hand 13 14a Did the organrzation receive any payments for indoor tanning servrces during the tax year? 14a If rYes,? has It ?led a Form 720 to report these payments? If ?No, 'provide an explanation in Schedule 0 14b BAA 05123114 Form 990 (2014) Form990(2014) GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Pages I Part VI IGovemance, Management, and Disclosure For each ?Yes?response to lines 2 through 7b below, and for - a ?No? response to line 83, 8b, or 10b 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. Governing Body and Management Yes No 1 a Enter the number of voting members of the governing body at the end of the tax year 1 a 5 if there are material differences in voting rights among members of the governing body. or if the governing body delegated broad authonty to an executive committee or similar committee. explain in Schedule 0. Enter the number of voting members included in line 13, above. who are independent 1 4 2 Did any of?cer. director. tmstee. or key employee have a family relationship or a business relationship With any other of?cer, director. trustee, or key empl0yee? 2 3 Did the organization delegate control over management duties customarily performed by or under the direct supervrsion of of?cers. directors. or trustees, or key employees to a management company or other person? 3 4 Did the organization make any Signi?cant changes to its gOVeming documents since the prior Form 990 was ?led? 4 5 Did the organization become aware during the year of a signi?cant diversmn of the organization's assets? 5 6 Did the organization have members or stockholders? 6 7 a Did the organization have members. stockholders. or other persons who had the power to elect or appornt one or more members of the governing body? 7 a Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders. or persons other than the goveming body? 7 8 Did the organization contemporaneously document the meetings held or wntten actions undertaken during the year by the followmg. a The governing body? 8 a Each committee authority to act on behalf of the governing body? 8 9 Is there any o?icer, 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 9 Section B. Policies (This Section requests information about policies not required by the Internal Revenue Code.) Yes No 10a Did the organization have local chapters. branches. or affiliates? 103 If 'Yes.? did the organization have written policies and procedures governing the activrties of such chapters. affiliates. and branches to ensure their operations are consistent With the organization's exempt purposes? 1 0 1 1 3 Has the organization provided a complete copy of this Form 990 to all members of Its governing body before ?ling the form? 1 1 a Descnbe in Schedule 0 the process. if any. used by the organization to reView this Form 990. 12a Did the organization have a wntten con?ict of interest policy? If 'No,?go to line 13 12a Were of?cers, directors, or trustees, and key employees reqmred to disclose annually interests that could give rise to con?icts? 12 Did the organization regulaity and consistently monitor and enforce compliance With the policy? If 'Yes,'descn'be in Schedule 0 how this was done 12 13 Did the organization have a written whistleblower policy? 13 14 Did the organization have a written document retention and destruction policy? 14 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 153 Other of?cers or key employees of the organization 15b If 'Yes' to line 153 or 15b, describe the process In Schedule 0 (see instructions). 16a Did the organization invest in, contribute assets to. or participate in a jornt venture or Similar arrangement with a taxable entity dunng the year? 163 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? 16!: Section C. Disclosure 17 List the states With which a copy of this Form 990 is requrred to be ?led Hawaii 18 Section 6104 requrres 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. Own website Another?s websrte Upon request Other (explain "1 0) 1 9 Describe in Schedule 0 whether (and if so. how) the organization made Its governing documents. con?ict 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 355 MERCHANT ST #3377 HONOLULU HI 96801 (808) 591-9193 BAA TEEA0106 11/13/14 Form 990 (2014) Form 999 (2014) GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Page? 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 Section A. Of?cers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a 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 of?cers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter 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 de?nition of 'key employee.? 0 List the organization's ?ve current highest compensated employees (other than an of?cer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form 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 of?cers, 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 capacny 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: indiVIdual trustees or directors, institutional trustees; of?cers; key employees, highest compensated employees; and former such persons. El Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C) ?massages?" 21"? (mg; 3 if a 3' (w-2/10 9-MISC) $3123.30" was: in 2% Isaac." organza- g. 2% 8 0 Organizations .323. 8 .3. dotted (31:2. line) to (.1). 313313119. 9 399114.139] 9 L5. CHAI RMAN 0 . 0 . 0 . ?911.14: LAM. Pi _Al< :1 0 104,143. 0. o. JEL E11 9 L59 TREASURER 0 . 0. 0 . ELLE E111 9. DI RECTOR 0 . . 0 . 139331! 93.3133 9 L09 DIRECTOR J2) J2) ?12) - ?11) L12) I 113) (14) BAA TEEA0107 02/27/14 Form 990 (2014) Form990(2014) GRASSROOT INSTITUTE OF HAWAII. INQ '99-0354937 Page_8 IPart lSection A. Of?cers, Directors, Trustees, KeLEmployees, and Highest Compensated Employees (continuer? (B) (0) . (A) Azemge $0 (D) (E) (F) :55: mass mama Mme?, memo("mange ?(statesmen mama? hours 9' 5 11 3 organization for IR ,2 and related related 3 a) organizations organize - tions 5 ?5 3 below g; 0 lune) 8 - O. 1135) I I 1?3) .J 11E) 112) - 122) (21) 123) 123) 121) - - 1bSub-total 104,143_ 0. 0_ Total from continuation sheets to Part VII, Section A dTotal(addlInes1band1c) 104,143_ 0. 0. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizatidn 1 . Yes No 3 Did the organization list any former of?cer. director. or trustee, key employee. or highest compensated employee . on line 1a? If ?Yes, complete Schedule for such individual 3 4 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 for such individual 4 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 5 Section B. Independent Contractors 1 Complete this table for your ?ve highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending With or within the organization's tax year. (A) (B) (0) Name and busmess address of sewices 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 BAA TEEA01 08 03/09/1 5 Form 990 (2014) Form 990 (2014) Part I Statement of Revenue Check if Schedule 0 contains a response or note to any line in this Part GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Page 9 Total revenue (B) Related or exempt function revenue (0) Unrelated business revenue (D) Revenue excluded from tax under sections 512-514 Contributions. Gifts. Grants 1 a Federated campaigns 1 a Membership dues 1 Fundraismg events 1 Related organizations 1 Governmentgrants(conlnbutions) . . 1 All other contnbulions, l?S, grants, and Similar amounts not in uded above. . 1f Noncash contributions Included in lines 1a-1t TotaI. Add lines 1a-1f 360,762. Program Service Revenue and Other SimilarAmoums Business Code 28 EVENTS NA 17,264. 17,264. All other program serwce revenue . Total. Add lines 2a-2f 17,264. Other Revenue 3 Investment income (including dividends, interest and other similar amounts) 4 Income from investment of tax-exempt bond proceeds . 5 Royalties 1.929. 1.929. (I) Real (II) Personal 6 a Gross rents Less rental expenses Rental Income or (loss). . Net rental income or (loss) I Secunties 7 a Gross amount from sales of (ii) other assels other than inventory Less cost or other basis and sales expenses . . . Gain or (loss) Net gain or (loss) 8 a Gross income from fundraising events (not including. of contributions reported on line 1c). See Part IV, line 18 a Less: direct expenses 9 a Gross income from gaming actiVIties. See Part IV, line 19 a Less: direct expenses 10 a Gross sales of inventory, less retums and allowances Less: cost of goods sold Net income or (loss) from fundraismg events Net income or (loss) from gaming activities Net Income or (loss) from sales of inventory Miscellaneous Revenue Buslness Code All other revenue Total. Add lines 11a?1 1d 12 Total revenue. See instructions 379. 955 . 17.264. l. 929. BAA TEEAO109 11l13/14 Form 990 (2014) Fonn990(2o14) I GRASSROOT INSTITUTE OF HAWAII, INC Part lX I Statement of Functional Expenses Section 501(c)(3) and 50 1(0) (4) organizations must complete all columns. All other organizations must complete column (A). Check if Schedule 0 contains a response or note to any line in this Part IX I 99-0354937 Page 10 Do 6b, not include amounts reported on lines 7b, 8b, 9b, and 10b of Part (3) (A) Total expenses Program service expenses (C) Management and general expenses (0) Fundraismg expenses 1 10 11 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 for? eign individuals. See Part IV, lines 15 and 16 . . Bene?ts paid to or for members Compensation of current of?cers. directors. tmstees. and key employees Compensation not included above. to disquali?ed persons (as de?ned under section 4958(f)(1)) and persons descnbed 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 bene?ts Payroll taXes Fees for sen/ices (non-employees). a Management Legal Accounting Professmnal fundraismg services. See Part IV. line 17 . Investment management fees 9 Other (ll line 119 am! exceeds 10% of line 25. column (A) amount, list line 119 expenses on Schedule 0) . . . Advertismg and promotion Of?ce expenses Information technology Royalties Occupancy Travel Payments of travel or entertainment expenses for any federal, state, or local public of?Cials Conferences. conventions. and meetings . . . Interest Payments to af?liates DepreCiation. depletion. and amortization . . . Insurance 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 24a expenses on Schedule 0.) a PRINTING All other expenses Total functional expenses. Add lines 1 through 24e. . Jolnt costs. Complete this line only if the organization reported in column (B) iomt costs from a combined educational campaign and fundraismg solicitation. Check here 1* iffollowing SOP 98-2 (ASC 958-720) BAA 104. 143. 64. 000. 40. 143 . 127. 193. 86.404. 40.789. 14. 980. 14. 980. 3.000. 3. 000 . 1.309. 1.309. 34.000. 34. 000 . 135. O. 135. 4.728. O. 4.728 . 2.362. O. 2.362. 0000 16.244. 0. 16.244. 0 7.728. 0. 7.728. 26.041. 23. 282 . 2.759. 723. 723. 836. 836. 4.984. 4.984. 0 4,730 2.478 4.730 0- 2.478 1.188- 188 1.000 2,596 596 2.000 11.711. 0. 11.711. 371, 109. 213, 200 . 157,909. TEEA011O 05/28/14 Fonn990(2014) Form 990(2014) INSTITUTE OF HAWAII. INC 99-0354937 Page 11 Eart I Balance Sheet Check if Schedule 0 contains a response or note to any line in this Part (A) (8) Beginning of year End of year 1 Cash non-interest?beanng Sayings and temporary cash investments 2 3 Pledges and grants receivable, net 3 4 Accounts receivableLoans and other receivables from current and former of?cers, directors. trustees ke em Io ees, and highest compensated employees. Complete PartllofSc edueE 5 6 Loans and other receivables from other disqualified persons (as de?ned 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? bene?CIary organizations (see instructions) Complete Part II of Schedule 5 7 Notes and loans receivable, net 7 8 Inventories for sale or use 3 9 Prepaid expenses and deferred charges 9 103 Land, buildings, and eqUIpment' cost or other ba5is. Complete Part VI of Schedule 103 Less: accumulated depreciation 10b Investments publicly traded securities 11 12 Investments other securities. See Part IV, line 11 12 13 Investments - program-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 34Accounts payable and accmed expenses Grants payable 13 19 Deferred revenue 19 1 00 . 20 Tax-exempt bond liabilities 20 3 21 Escrow or custodial account liability. Complete Part IV of Schedule 21 22 Loans and other payables to current and former of?cers, directors, trustees, I '5 key employees. highest compensated employees, and disquali?ed persons. 3 Complete Part II of Schedule 22 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 througLZS Organizations that follow SFAS 117 (A56 958), check here Band complete I 8 lines 27 through 29, and lines 33 and 34. 5 27 Unrestricted net assets 27 28 Temporarily restricted net assets 23 29 Permanently restricted net assets 29 Organizations that do not follow SFAS 117 (A56 958). check here and complete lines 30 through 34. 30 Capital stock or trust principal, or current funds 30 8 31 Paid-in or capital surplus, or land, building, or equipment fund 31 2 32 Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances Total liabilities and net assets/fund balances BAA Form 990 (2014) TEEAO111 05128114 Form990l2014) GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Part XI Reconciliation of Net Assets Page 12 Check if Schedule 0 contains a response or note to any line in this Part Xl 1_ Total revenue (must equal Part column (A), line 12Total expenses (must equal Part IX, column (A), line 25Revenue less expenses. Subtract line 2 from line Net assets or fund balances at beginning of year (must equal Part X. line 33, column 4 8 . 8 54 5 Net unrealized gains (losses) on investments 5 6 Donated services and use of facilities 6 7 Investment expenses 7 3 Pnor penod adjustments 3 9 Other changes In net assets or fund balances (explain in Schedule 0) 9 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33. column 10 1'7, 700 - IPart XII IFinancial Statements and Reporting Check if Schedule 0 contains a response or note to any line in this Part 1 Accounting method used to prepare the Form 990: 'Cash DAccrual DOther Yes No If the organization changed Its method of accounting from a prior year or checked '0ther,? explain in Schedule 0. 2 3 Were the organization's ?nanc1al statements compiled or reviewed by an independent accountant? lf 'Yes,? check a box below to indicate whether the ?nancual statements for the year were compiled or reviewed on a S?arate consolidated baSlS, or both: Separate basrs DConsolidated baSIs DBoth consolidated and separate baSlS Were the organization's ?nanaal statements audited by an independent accountant? If 'Yes,? check a box below to indicate whether the ?nancial statements for the year were audited on a separate ba5is. consolidated bas:s, or both: Separate baSlS DConsolidated baSlS DBoth consolidated and separate basis If 'Yes? to line 2a or 2b. does the organization have a committee that assumes responsrbility for oversight of the audit, reVIew, or compilation of its ?nancial 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 reqmred to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular If '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 2b 3a 3b BAA 05/28/14 Form 990 (2014) SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury lntemai Revenue Sennce Public Charity Status and Public Support chasm-154541047 Complete if the organization is a section 501(c)(3) organization or a section 201 4 nonexempt charitable trust. Attach to Form 990 or Form Information about Schedule A (Form 990 or 990-EZ) and its instructions is 05::2 to 5:22? at pe Name of the organization GRASSROOT INSTITUTE Employer Identi?cation number OF HAWAII, INC 99-0354937 I Part I IReason for Public Charity Status (All ogganizations must complete this part.) See instructions. The organization Is not a pnvate foundation because it is: (For lines 1 through 11. check only one box.) 1 A church. convention of churches. or association of churches described in section 2 A school described in section (Attach Schedule E.) 3 A hospital or a cooperative hospital sewice organization described in section 170(b)(1)(A)(Iii). 4 A medical research organization operated in conjunction With a hospital described in section Enter the hospital's name. city, and state: An or anization operated for the bene?t of a college or university owned or operated by a governmental unit described in section 170(b (Complete Part ll.) 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.) A community trust described in section (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 of its support from gross investment income and unrelated business taxable income (less section 511 tax) from busrnesses aoqurred by the organization after June 30. 1975. See section 509(a)(2). (Complete Part ill.) 10 An organization organized and operated excluswely to test for public safety. See section 509(a)(4). 11 An organization organized and operated excluswely for the bene?t 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 119. a El Type I. A supporting organization operated. supewised, or controlled by its supported organization(s). typically by giving the supported organization(s) the power to regularly appomt 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 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 W, 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 lV. Sections A, D, and E. 0. El 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. CD Check this box if the organization received a written determmation from the IRS that is a Type l, Type II. Type ill functionally integrated. or Type non?functionally Integrated supporting organization. -.. Enter the number of supported organizations I: Prowde the following information about the supported organization(s). Name 0! supported (ll) EIN (ill) Type of organization (iv) is the Amount of monetary (vl) Amount of other organization (described on lines 1-9 organization listed support (see instructions) support (see instructions) above or IRC section in your governing (see document?I Yes No (A) (B) (C) (D) (E) Total BAA For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ Schedule A (Form 990 or 990-EZ) 2014 TEEAO401 07/16/14 Schedule A (Form 990 or 990-E2) 2014 GRASSROOT INSTITUTE OF HAWAII INC 9 9?0 3 54 937 Page 2 [Part II ISupport 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 if the organization fails to qualify under the tests listed below, please complete Part section A. Public Support Calendar year (or ?scal year beginning in) 2010 2011 2012 2013 2014 Total 1 Gifts, grants, contributions, and membership fees received not include any 'unusual grants . . . 2 Tax revenues levred for the organization's bene?t and either paid to or expended on its behalf 3 The value of services or facilities fumished 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 . . 6 Public support. Subtract line 5 from line 4 Section B. Total Support Calendar year (or ?scal year beginning in) 2010 2011 2012 2013 2014 Total 7 Amounts from line 4 8 Gross income from interest, divrdends, payments received on securities loans, rents, royalties and income from Similar sources 9 Net income from unrelated busrness actiwties, whether or not the busmess is regularly carned 0n 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) D2 13 First five years. If the Form 990 is for the organization's ?rst, second, third, fourth, or ?fth tax year as a section 501(c)(3) organization, check this box and stop here El Section C. Computation of Public Support Percentage 14 Public support percentage for 2014 (line 6, column divrded by line 11, column (0) 14 15 Public support percentage from 2013 Schedule A, Part II, line 14 15 16a support test 2014. If the organization did not check the box on line 13, and the line 14 is 33-1/3% or more, check this box and stop here. The organization quali?es as a publicly supported organization support test - 2013. If the organization did not check a box on line 13 or 163, and line 15 is 33-1l3% or more, check this box and stop here. The organization quali?es as a publicly supported organization 17a 10%-facts-and-circumstances test 2014. 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-crrcumstances' test, check this box and stop here. Explain in Part VI how the organization meets the 'facts?and-crrcumstances? test. The organization quali?es as a publicly supported organization 10%-facts-and-circumstances test 2013. If the organization did not check a box on line 13, 163, 16b, or 173, 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 quali?es as a publicly supported organization 18 Private foundation. If the organization did not check a box on line 13, 163, 16b, 173, or 17b, check this box and see instructions BAA Schedule A (Form 990 or 990-EZ) 2014 TEEAO402 07/16/14 Schedule A (Form 990 or 990-E2) 2014 GRASSROOT INSTITUTE OF HAWAI I INC 9 9?0354 937 Page 3 I Part iSupport 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 Calendar year (or ?scal yr beginning in) 2010 2011 2012 2013 2014 Total 1 Gifts, grants. contributions and membership fees received (Do not include any'unusualgrants.') 507,161. 173,852. 151,988. 304,597. 360,762. 1,498,360. 2 Gross receipts from admis- SlOl?lS, merchandise sold or services performed. or facilities furnished in any actiwty that IS related to the organization's tax-exemptpurpose 16,431. 16,256. 12,124. 15,302. 17,264. 77,377. 3 Gross receipts from activities that are not an unrelated trade or busmess under section 513 . 4 Tax revenues leVIed for the organization's bene?t and either paid to or expended on Its behalf 5 The value of sewices or faCIlltleS furnished by a govemmental unit to the organization Without charge. . . 6 .- 523,592. 190,108. 164,112. 319,899. 378,026. 1,575,737. 7 a Amounts included on lines 1. 2. and 3 received from disquali?edpersons 44,377. 42,283. 33,340. 66,468. 70,652. 257,120. Amounts included on lines 2 and 3 received from other than disquali?ed persons that exceed the greater of $5,000 or 1% of the amount on line 13 fortheyear 32,286. 18,500. 17,510. 49,386. 179,370. 297,052. cAddlines7aand7b 76,663. 60,783. 50,850. 115,854. 250,022. 554,172. 8 Public support (Subtract line 7cfromline6.) 1,021,565. Section B. Total Support Calendar year (or fiscal yr beginning in) 2010 2011 2012 2013 2014 (0 Total 9 523,592. 190,108. 164,112. 319,899. 378,026. 1,575,737. 1 0 a Gross income from interest, diVidends. payments received on secunlies loans, rents, royalties and income from Similarsources 82. 34. 3. 1,929_ 2.048. Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30. 1975 . . cAddlines10aand10b 82. 34. 3. 1,929. 2,048. 1 1 Net income from unrelated busmess activuies not included in line 10b, whether or not the busmess is regularty carried on 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) 13 Total support. (Add lines 9. 10c,11and12.) 523,674. 190,142. 164,115. 319,899. 379,955. 1,577,785. 14 First ?ve years. If the Form 990 is for the organization's ?rst. 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 2014 (line 8. column dwided by line 13, column Public support percentage from 2013 Schedule A, Part line 15 16 7 7 31 Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2014 (line 10c, column divided by line 13. column 17 0 1 3 18 investment income percentage from 2013 Schedule A. Part line 17 18 0 . 05 19a support tests 2014. If the organization did not check the box on line 14. and line 15 is more than and line 17 is not more than check this box and stop here. The organization quali?es as a publicly supported organization support tests 2013. If the organization did not check a box on line 14 or line 19a. and line 16 is more than 33-1l3%, and line 18 is not more than check this box and stop here. The organization quali?es as a publicly supported organization 20 Private foundation. If the organization did not check a box on line 14. 193, or 19b. check this box and see instructions BAA memos 07/17/14 Schedule A (Form 990 or 990-52) 2014' ScheduleMForm GRASSROOT INSTITUTE OF HAWAII, INC 99?0354937 Page4 Part IV ISupporting Organizations (Complete only if you checked 8 box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part l, 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 Yes No 1 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. lf designated by class or purpose, describe the desrgnation. lf histonc and continuing relationship, explain 1 2 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) 2 3 3 Did the organization have a supported organization described in section 501(c)(4), (5), or If ?Yes,?answer - and below 3a Did the organization con?rm that each supported organization quali?ed under section 501(c)(4). (5). or (6) and satis?ed the public support tests under section 509(a)(2)? If ?Yes, describe in Part VI when and how the organization made the determination 3b 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 3c 4 3 Was any supported organization not organized in the United States ('foreign supported organization')? If ?Yes?and if you checked 11a or 11b in Part I, answer and below 4a 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 supervrsed by or in connection with its supported organizations 4b Did the organization support any foreign supported organization that does not have an 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 exclusively for section 170(0) (2) (B) purposes 4c 5 a Did the organization add, substitute, or remove any supported organizations dunng the tax year? If 'Yes,? answer and below (if applicable). Also, provide 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?s organizing document authorizrng such action, and (iv) how the action was accomplished (such as by a amendment to the organizing document) 5a Type I or Type II only. Was any added or substituted supported organization part of a class already desrgnated in the organization's document? 5b Substitutions only. Was the substitution the result of an event beyond the organization's control? 5c 6 Did the organization provide support (whether in the form of grants or the provisron of servrces or facrlities) to anyone other than (3) its supported organizations; individuals that are part of the charitable class bene?ted by one or more of its supported organizations; or other supporting organizations that also support or bene?t one or more of the ?ling organization's supported organizations? If ?Yes,? provide detail in Part VI 6 7 Did the organization prowde a grant, loan, compensation, or other Similar payment to a substantial contributor (de?ned in IRC a family member of a substantial contn'butor, or a 35-percent controlled entity with regard to a substantial contributor? If ?Yes, complete Part I of Schedule (Form 990) 7 8 Did the organization make a loan to a disquali?ed person (as de?ned in section 4958) not described in line 7? If ?Yes,? complete Part of Schedule (Form 990) 8 9 a Was the organization controlled directly or indirectly at any time during the tax year by one or more disquali?ed persons as de?ned in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or . If ?Yes, provide detail in Part VI ga I) Did one or more disquali?ed persons (as de?ned in line hold a controlling interest in any entity in which the supporting organization had an interest? If ?Yes,'provide detail in Part VI 9b Did a disquali?ed person (as de?ned in line have an ownership interest in, or denve any personal bene?t from, assets in which the supporting organization also had an interest? if ?Yes,'piovrde detail in Part VI 9c 10 :3 Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations. and all Type non-functionally integrated supporting organizations)? If 'Yes, answer below 1 0a Did the organization, have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determme whether the organization had excess business holdings.) 1 0b BAA TEEAO404 07/17/14 Schedule A (Form 990 or 2014 ScheduleA(Form 990 or990-EZ)2014 GRASSROOT INSTITUTE OF HAWAII, INC 99-0354937 Page 5 [Part IV [Supporting Organizations (continued) Yes No 11 Has the organization accepted a gift or contribution from any of the following persons? a A person who directly or indirectly controls. either alone or together with persons described in and below, the governing body of a supported organization? 1 1a A family member of a person described in above? 1 1 A 35% controlled entity of a person described in or above? If 'Yes' to a, b, or c, prowde detail in Part VI 11c Section 3. Type I Supporting Organizations Yes 1 Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appomt or elect at least a majority of the organization's directors or trustees at all times dunng the tax year? If ?No, describe in Part VI how the supported organization(s) effectively operated, supervrsed, or controlled the organization's actiwtres. If the organization had more than one supported organization, describe how the powers to appornt 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 1 2 Did the organization operate for the bene?t of any supported organization other than the supported organization(s) that operated. superwsed, or controlled the supporting organization? If 'Yes, explain in Part VI how prowding such bene?t canted out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization 2 Section C. Type II Supporting Organizations Yes No 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)? lf ?No, 'descnbe in Part VI how control or management of the supporting organizati0n was vested in the same persons that controlled or managed the supported organization(s) 1 Section D. All Type Supporting Organizations Yes 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, (1) a written notice descnbing the type and amount of support prowded during the prior tax year, (2) a copy of the Form 990 that was most recently ?led as of the date of noti?cation, and (3) copies of the organization's governing documents in effect on the date of noti?cation. to the extent not prevrously provided? 1 2 Were any of the organization?s of?cers, directors, or trustees either appointed or elected by the supported i organization(s) or (ii) 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) 2 3 By reason of the relationship descnbed in (2). did the organization's supported organizations have a signi?cant vorce 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 VI the role the organization's supported organizations played in this regard 3 Section E. Type Functionally-Integrated Supporting Organizations 1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions): a The organization satis?ed 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) 2 ActIVIties Test. Answer and below. Yes No a Did substantially all of the organization's activities during the tax year direc?y further the exempt purposes of the supported organization(s) to which the organization was responswe? If 'Yes,?then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsrve to those supported organizations, and how the organization determrned that these activities constituted substantially all of its actiwties Za Did the actiVities 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 '5 involvement 2b 3 Parent of Supported Organizations. Answer and below. a Did the organization have the power to regularly appoint or elect a majority of the of?cers. directors. or trustees of each of the supported organizations? Provide details in Part VI 3a Did the organization exercise a substantial degree of direction over the policies, programs. and activities of each of its supported organizations? If 'Yes, describe in Part the role played by the organization in this regard 3b BAA TEEAD405 07/13/14 Schedule A (Form 990 or 990-EZ) 2014 ScheduleMForm 990 or 990-E2) 2014 GRASSROOT INSTITUTE OF HAWAII, [Part [Type Non-Functionally Integrated Supporting Organizations Check here if the organization satis?ed the Integral Part Test as a qualifying trust on November 20, 1970. See instructions. All other Type non-functionally integrated supporting organizations must complete Sections A through E. 1 INC 99-0354937 PageG Section A Adjusted Net Income (A) Prior Year (B) Current Year (optional) Net short-term capital gain Recovenes of pnor-year distnbutiOns Other gross income (see Add lines 1 through 3 Deprecraiion and depletion Ultth-i minnows- 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) O) 7 Other expenses (see instructions) Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) Section Minimum Asset Amount (A) Pnor Year (B) Current Year (ophonal) 1 Aggregate fair market value of all non-exempt-use assets (see Instructions for short tax year or assets held for part of year): 3 Average value of securities Average cash balances 1b Falr market value of other non-exempt?use assets 1c Total (add lines 13, 1b, and 1c) 1d Discount claimed for blockage or other factors (explain in detail in Part VI): AchISItion indebtedness applicable to non-exempt-use assets (AI Subtract line 2 from line 1d Cash deemed held for exempt use Enter 1-1/2% of line 3 (for greater amount. see instructions) Net value of non-exempt-use assets (subtract line 4 from line 3) Multiply line 5 by .035 Recovenes of pnor?year distributions ??4901 Minimum Asset Amount (add line 7 to line 6) Section Distributable Amount Current Year Adjusted net income for pnor year (from Section A, line 8, Column A) Enter 85% of line 1 Minimum asset arriOUnt for prior year (from Section 3, line 8, Column A) Enter greater of line 2 or line 3 Income tax imposed in prior year UlinN-B 7 Check here if the current year is the organization's ?rst as a non?functionalIy-integrated Type supporting organization Distributable Amount. Subtract line 5 from line 4. unless subject to emergency temporary reduction (see instructions) (see instructions). BAA TEEAO406 07/18/14 6 Schedule A (Form 990 or 990-EZ) 2014 Schedule A (Form 990 or 990-EZ) 2014 Page 7 [Part IType Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Section Distributions Current Year 1 Amounts paid to supported organizations to accomplish exempt purposes 2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations. in excess of income from actiwty 3 Administrative expenses paid to accomplish exempt purposes of supported organizations 4 Amounts paid to acquire exempt-use assets 5 Qualified set?aside amounts (pnor IRS approval required) 6 Other distributions (describe in Part VI). See instnictions 7 Total annual distributions. Add lines 1 through 6 8 Distnbutions to attentive supported organizations to which the organization is responsuve (provrde details In Part VI). See instructions 9 Distributable amount for 2014 from Section C, line 6 10 Line 8 amount diVided by Line 9 amount . Section Distribution Aliocations (see instructions) Dif?g??ms 1 Distributable amount for 2014 from Section C, line 6 2 Underdistributions. If any, for years prior to 2014 (reasonable cause reqUIred see instructions) 3 Excess distributions carryover. if any, to 2014: a From 2013 Total of lines 33 through 9 Applied to underdistnbutions of prior years Applied to 2014 distn'butable amount Carryover from 2009 not applied (see instructions) Remainder. Subtract tines 39, 3h, and Si from 3f Distributions for 2014 from Section D. line 7: a Applied to underdistnbutions of prior years Applied to 2014 distributable amount Remalnder. Subtract lines 43 and 4b from 4 5 Remaining underdistnbutions for years prior to 2014, if any. Subtract lines 39 and 4a from line 2 (if amount greater than zero, see instructions) 6 Remaining underdistnbutions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) 7 Excess distributions carryover to 2015. Add lines Breakdown of line 7 a Excess from 2013 Excess from 2014 BAA TEEA0407 10/31/14 Schedule A (Form 990 or 990-EZ) 2014 ScheduleMForm GRASSROOT INSTITUTE OF HAWAII, INC 99?0354 937 Page8 liR'a'ntSV'g l?l Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part line 12. Also complete this part for any additional information. (See instructions). BAA Schedule A (Form 990 or 990-EZ) 2014 TEEA0408 08/18/14 SCHEDULE Supplemental Financial Statements OMB No 1545-0047 (Form 990) Complete if the organization answered 'Yes,? to Form 990, 201 4 Part N, lines 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e. 11f,12a, or 12b. Denamem lnfonnation about Schedule (Form 990) and Its instructions is at Intemal Revenue Servrce Name of the organization GRASSROOT INSTITUTE OF HAWAII, Attach to Form 990. Open to Public Inspection Employer identi?cation number INC 99?0354937 IPartI Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered ?Yes? to Form 990, Part IV, line 6. 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 Donor advrsed funds Funds and other accounts Did the organization Inform all donors and donor adVisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control? DYes No 6 Did the organization inform all grantees, donors, and donor advrsors In writing that grant funds can be used only for chanta imperrnissible private benefit? IPart II I Conservation Easements. le purposes and not for the bene?t of the donor or donor advisor. or for any other purpose conferring DYes El No Complete if the organization answered ?Yes? to 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) EPreservation of a histoncalty important land area Protection of natural habitat Preservation of open space Preservation of a certi?ed historic structure 2 Complete lines 2a through 2d if the organization held a quali?ed 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 2 a Total acreage restricted by conservation easements 2 Number of conservation easements on a certi?ed historic struoture included in 2 Number of conservation easements included in acquired after 8/17/06, and not on a historic structure listed in the National Register 2 3 Number of conservation easements modified, transferred. released, extingtushed, or terrninated by the organization during the tax year 4 Number of states where property subject to conservation easement is located 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of Violations, and enforcement of the conservation easements it holds? 6 Staff and volunteer hours devoted to monitoring, inspecting, and conservation easements during the year 7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year 8 Does each conservation easement reported on line 2(d) above satisfy the requrrements of section and sectton DYes 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 [Part In Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered ?Yes' to Form 990, Part IV, line 8. 1 a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, histoncai treasures, or other Similar assets held for public exhibition, education, or research in furtherance of public servrce, provrde, in Part the text of the footnote to its financial statements that describes these items. If the organization elected, as pennitted under SFAS 116 (ASC 958). to report in its revenue statement and balance sheet works of art, histoncai treasures, or other Similar assets held for public exhibition, education, or research in furtherance of public sewice, prowde the followrng amounts relating to these items: (I) Revenue included in Form 990, Part line 1 (ii) Assets included in Form 990, Part vs 2 If the organization received or held works of art, histoncai treasures, or other similar assets for ?nancial gain, provrde the followmg amounts required to be reported under SFAS 116 (ASC 958) relating to these items: a Revenue included in Form 990, Part line 1 . . . Assets included in Form 990, Part BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. TEEA3301 10/28/14 Schedule (Form 990) 2014 Schedule (Form 990) 2014 GRASSROOT INSTITUTE OF HAWAII INC 99?0354 937 Page 2 [gm Ill jOannizations MaintainingCollections of ArtI Historical Treasures, or Other Similar Assets (continued) 3 Usmg?the organization's acquismon, accessmn, and other records, check any of the followrng that are a signi?cant use of its collection items (check all that apply): a Public exhibition Loan or exchange programs Scholarly research Other Preservation for future generations 4 Erwig?la description of the organization's collections and explain how they further the organization's exempt purpose in a . 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 'IPart IV Escrow and?stodial Arrangements. Complete if the organization answered ?Yes? to Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. 1 a Is the organization an agent, tnistee, custodian, or other intermediary for contributions or other assets not included on Form 990, Part Yes No If 'Yes,? explain the arrangement in Part and complete the following table: Amount Beginning balance 1 Additions dunng the year 1 Distributions during the year 1 Ending balance 1 2 a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? Yes No If 'Yes,? explain the arrangement in Part Check here if the explanation has been provided in Part Part {Endowment Funds. Comlete if the organization answered ?Yes? to Form 990, Part IV, line 10. Current year Prior year Two years back Three years back Four years back 1 a Beginning of year balance . . . Contributions Net investment earnings. gains, and losses Grants or scholarships Other expenditures for faCilities and programs 1? 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 in lines 2a. 2b, and 2c should equal 100%. 3 a Are there endowment funds not in the possessmn of the organization that are held and administered for the organization by: Yes No unrelated organizations 33(i) (ii) related organizations 33(ii) If 'Yes? to 3a(ii), are the related organizations listed as reqUired on Schedule 3b 4 Describe in Part the intended uses of the organization's endowment funds. [Part VI ILand, Buildings, and Equipment. Complete if the organization answered ?Yes? to Form 990, Part IV, line 113. See Form 990, Part X, line 10. Description Of Property Cost or other basrs Cost or other Accumulated (6) Book value (investment) (other) depmaation 1 a Land BUIldings Leasehold improvements quUiPment 4.542. 1,368. 3,174_ Other Total. Add lines 1a through 1e. (Column must equal Form 990, Part X, column (B), line 10c.) 3 1 7 4 BAA Schedule (Form 990) 2014 TEEA3302 Schedule (Form 990) 2014 GRASSROOT INSTITUTE OF HAWAI I INC 99?0354 937 Page 3 [Part VII [Investments Other Securities. . Complete if the organization answered 'Yes? to Form 990, Part IV, line 11b. See Form 990, Part X, line 12. Description of security or category Gncluding name of security) 300k value Method of valuallon: Cost or end-ol-year market value Financral derivatives (2) Closely-held equity interests (3) Other Total (Column must equal Form 990, Part X, column (B) line 12 . . rt vm Investments - Pro ram Related. Complete if the orga?1ization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13. Description of investment type Book value Method of valuation: Cost or end-of-year market value (1) (2) (3) 14) (5) (5) (7) 45) (9) (10) Total. Column must -uaIFonn 990, column (marge 13 . Other Assets. Com if the answered ?Yes' to Form 990 Part IV line 11d. See Form 990 Part line 15. Book value Total. (Column must equal Form 990, PartX, column line 15.) Other Liabilities. if the answered 'Yes? to Form 990 Part IV line He or 11f. See Form 990 Part line 25 of Book value a 1 Federal income taxes (2) 3 (4) (5) 6 8 (10) 11 Total must Form Part X, column line 25 . . . 2. Liability for uncertain tax posllions ln Pan provide the text of the footnote to the organization's ?nancial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740) Check here if the text of the footnote has been provrded in Part BAA TEEA3303 08/25114 Schedule (Form 990) 2014 Schedule 0 (Form 990) 2014 GRASSROOT INSTITUTE OF HAWAII, INC 99-0354 937 Page4 IPart XI IReconciIiation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a. 1. Total revenue, gains, and other support per audlted ?nancial statements 1 2 Amounts included on line 1 but not on Form 990, Part line 12: a Net unrealized gains (losses) on investments 2 a Donated services and use of facrlities 2 Recovenes of pnor year grants 2 Other (Describe in Part 2 Add llnes 2a thr0ugh 2d . . . 2 3 Subtract line 2e from line 1 . . . 3 4 Amounts included on Form 990, Part line 12, but not on line 1. a Investment expenses not included on Form 990, Part We Th 4a Other (Descnbe In Part 4 Add lines 4a and 4b 4c 5 Total revenue. Add ?ms 3 and 4c. (This must equal Form 990, Part I, [we 12.) 5 IPart XII [Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered ?Yes? to Form 990, Part IV, line 12a. 1 Total expenses and losses per audited ?nancral statements 1 2 Amounts included on line 1 but not on Form 990, Part IX, line 25: a Donated semoes and use of facilities 2 a Pnor year adjustments 2 Other losses 2 Other (Descnbe in Part 2 Add lines 2a through 2d . . . 2 3 Subtract line 2e from line 1 . . . 3 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 4 Add llnes 4a and 4b 4c 5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) 5 IPart I Supplemental Information. Provrde the requrred for Part II, lines 3. 5, and 9; Part lines 1a and 4, Part IV, lines 1b and 2b; Part V, line 4; Part X, llne 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to prowde any additional information. BAA Schedule (Form 990) 2014 TEEA3304 10/28114 OMB No 1545-0047 SCHEDULE Noncash Contributions (Form 990) 201 4 . Complete if ?le organizations answered ?Yes? on Form 990, Part lines 29 or 30. Attach to Form 990. Open To Public ?fgg'gf?ggig??smgw Information about Schedule (Form 990) and its Instructions is at inspection Name of the organization Employer identi?cation number GRASSROOT INSTITUTE OF HAWAII, INC 99-0354937 [Partl lTypes of Property a Check if Number of Noncash contribution Method of determining applicable contributions or amounts reported noncash contribution amounts items contributed on Form 990. Part line 19 Art - Works of art Art Historical treasures Art Fractional interests Books and publications Clothing and household goods Cars and other vehicles Boats and planes Intellectual property monument-cone Securities Publicly traded Securities Closely held stock a A A Securities Partnership. LLC. or trust interests. . 12 Securities Miscellaneous 13 Quali?ed conservation contribution - Historic structures 14 Quali?ed conservation contribution Other. . . . 15 Real estate Residential 16 Real estate Commercial 17 Real estate - Other 18 Collectibles 19 Food inventory 20 Drugs and medical supplies 21 Taxrdermy 22 Historical artifacts 23 SCIenti?c specrmens 24 Archeologrcai artifacts 25 Other> 26 Other> 27 Other? 28 Other> 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 54qu a Yes No 30a During the year, did the organization receive by contribution any property reported in Part I, lines 1-28, that it must hold for at least three years from the date of the initial contribution, and which is not requrred to be used for exempt . purposes for the entire holding period? 303 If ?Yes,? describe the arrangement in Part II. 31 Does the organization have a gift acceptance policy that requires the revrew of any non-standard contributions? 31 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. 33 If the organization did not report an amount in column for a type of property for which column is checked. describe in Part ll. BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule (Form 990) (2014) TEEM601 0928/14