53
PUBLIC DISCLOSURE COPY PLEASE FILE IN A SAFE PLACE ARMANINO LLP 55 Almaden Blvd., Suite 600 San Jose, CA 95113 ph 408.494.1200 fx 408.279.8186
PUBLIC DISCLOSURE COPY
PLEASE FILE IN A SAFE PLACE
ARMANINO LLP
55 Almaden Blvd., Suite 600 San Jose, CA 95113 ph 408.494.1200 fx 408.279.8186
Form 990 Department of the Treasury Internal Revenue Service
** PUBLIC DISCLOSURE COPY **
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 public.
• Information about Form 990 and its instructions is at www in* nnv/fnrmQQO
OMB No. 1545-0047
Open to Public )pen to Public Inspection
A For the 2015 calendar year, or tax year beginning and ending
B Check if applicable:
•Address
change
• Name
change
• Initial
return
• Final
return/
C Name of organization
RONALD MCDONALD HOUSE AT STANFORD Doing business as
D Employer identification number
9 4 - 2 5 3 8 6 1 5 Number and street (or P.O. box if mail is not delivered to street address)
520 SAND HILL ROAD Room/suite E Telephone number
( 6 5 0 ) 4 7 0 - 6 0 0 0
• Amended
return Application pending
City or town, state or province, country, and ZIP or foreign postal code
PALO ALTO, CA 94304 G Gross receipts $ 1 4 , 4 1 8 , 2 0 5 .
• F Name and address of principal officer: A N N E T T E E R O S
SAME AS C ABOVE I Tax-exempt status: f X ] 5Q1(c)(3) I I SOIfcH
J Website: • WWW. RMHSTANFORD. ORG X (insert no.) I 1 4947(a)<Jl)or I I 527
H(a) Is this a group return
for subordinates? I I Yes I X I No
H ( b ) Are all subordinates included? I I Y e s I I N o
If "No," attach a list, (see instructions)
H(c) Group exemption number •
Year of formation: 1 9 7 9l M State of leoal domicile: C A K Form of organization: f X l Corporation I I Trust | | Association | | Other •
| Part 11 Summary 1 Briefly describe the organization's mission or most significant activities: R O N A L D M C D O N A L D H O U S E I S A
NURTURING HOME FOR CRITICALLY ILL CHILDREN AND THEIR FAMILIES. Check this box • I I if the organization discontinued its operations or disposed of more than 25% of its net assets
Number of voting members of the governing body (Part VI, line la)
Number of independent voting members of the governing body (Part VI, line 1 b)
Total number of individuals employed in calendar year 2015 (Part V, line 2a)
Total number of volunteers (estimate if necessary)
7 a Total unrelated business revenue from Part VIM, column (C), line 12
b Net unrelated business taxable income from Form 990-T, line 34
7a
7b
22 21 43
3609 0 . 0 .
8 Contributions and grants (Part VIII, line 1h)
9 Program service revenue (Part VIII, line 2g)
10 Investment income (Part VIII, column (A), lines 3,4, and 7d)
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)
12 Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12)
Prior Year Current Year
8,688,873 10,911,068 156,513 120,418 633,413 505,460 419,422 116,449
9,898,221 11,653,395 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)
14 Benefits paid to or for members (Part IX, column (A), line 4)
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
16a Professional fundraising fees (Part IX, column (A), line l i e )
b Total fundraising expenses (Part IX, column (D), line 25) • 812 , 645 .
17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
0 0
1 , 7 2 6 , 1 7 9 2 , 0 8 6 , 6 2 5 5 6 , 3 5 7
2 , 3 2 6 , 4 3 2 2 , 3 6 9 , 9 4 2 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
19 Revenue less expenses. Subtract line 18 from line 12
4 , 1 0 8 , 9 6 8 4 , 4 5 6 , 5 6 7 5 , 7 8 9 , 2 5 3 7 , 1 9 6 , 8 2 8
Beginning of Current Year End of Year
t o n 20 Total assets (Part X, line 16)
21 Total liabilities (Part X, line 26)
22 Net assets or fund balances. Subtract line 21 from line 20
76,546,138. 93,727,009 1,279,904. 12,302,717
| Part II j Signature Bloc f 7 5 , 2 6 6 , 2 3 4 . 8 1 , 4 2 4 , 2 9 2
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign
Here
Paid
Preparer
Use Only
L ^ Signature of officer Date
^ ANNETTE EROS, CEO P Type or print name and title
Print/Type preparer's name
LAWRENCE S . KUECHLER Preparer's signature
LAWRENCE S . KUECHLER
Date
0 8 / 1 1 / 1 6 Firm's name fe. ARMANINO L L P Firm's address • 1 2 6 5 7 ALCOSTA B L V D , S T E . 5 0 0
SAN RAMON, CA 9 4 5 8 3 - 4 6 0 0
Check 1 1 if ' ' self-employed
PTIN
P00233621 Firm'sEINb- 9 4 - 6 2 1 4 8 4 1
Phone n o . 9 2 5 - 7 9 0 - 2 6 0 0 May the IRS discuss this return with the preparer shown above? (see instructions) fX l Yes I I No 532001 12-16-15 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 9 9 0 (2015)
Form990(2015) RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Paae2 I Part II! I Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III I X I 1 Briefly describe the organization's mission:
RONALD MCDONALD HOUSE AT STANFORD CREATES A HOME-AWAY-FROM-HOME AND SUPPORTIVE COMMUNITY FOR FAMILIES OF CHILDREN WITH LIFE-THREATENING ILLNESSES RECEIVING SPECIALIZED TREATMENT AT LOCAL HOSPITALS.
2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? [ZIlYes [ X ] No If "Yes," describe these new services on Schedule O.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? I I Yes I X I No If "Yes," describe these changes on Schedule O.
4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501 (c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4 a (Code: ) (Expenses $ 3 , 1 3 6 , 5 9 0 . including grants of $ ) (Revenue $ I z U / 4 J . O » )
RONALD MCDONALD HOUSE AT STANFORD (RMHS) OWNS AND OPERATES RONALD MCDONALD HOUSE (HOUSE) IN PALO ALTO, NEAR LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD AND STANFORD MEDICAL CENTER. THE HOUSE CREATES A HOME-AWAY-FROM-HOME AND SUPPORTIVE COMMUNITY FOR FAMILIES OF CHILDREN WITH LIFE-THREATENING ILLNESSES RECEIVING SPECIALIZED TREATMENT AT LOCAL HOSPITALS. THE HOUSE PROVIDES TEMPORARY LODGING TO FAMILIES OF CRITICALLY ILL CHILDREN WHO MUST LEAVE THEIR OWN COMMUNITY TO SEEK MEDICAL CARE FOR THEIR CHILD. AS A RESULT OF INCREASED DEMAND FOR ITS SERVICES, THE HOUSE OPENED A NEW FACILITY IN 2016 DIRECTLY ADJACENT TO THE EXISTING HOUSE. SEE SCHEDULE O FOR CONTINUATION.
4 b (Code: ) (Expenses $ ^ ^ ^ _ _ _ _ ^ ^ ^ ^ ^ ^ ^ ^ ^ _ _ _ including grants of $ ) (Revenue $ )
4 C (Code: ) (Expenses $ including grants of $ ) (Revenue $ _
4d Other program services (Describe in Schedule O.) (Expenses $ including grants of $ ) (Revenue $ )
4e Total program service expenses • 3 , 1 3 6 , 5 9 0 .
532002 12-16-15
Form 9 9 0 (2015)
Form 990 (20151 RONALD MCDONALD HOUSE AT STANFORD | Part IV} Checklist of Required Schedules
9 4 - 2 5 3 8 6 1 5 Paae3
1 Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)?
If "Yes," complete Schedule A
2 Is the organization required to complete Schedule B, Schedule of Contributors'? 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office? if "Yes," complete Schedule C, Part I 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 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 defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to
provide advice on the distribution or investment of amounts in such funds or accounts? if "Yes,' complete Schedule D, Part I
7 Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? if "Yes," complete Schedule D, Part II
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? if "Yes," complete
Schedule D, Part III 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 X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
If "Yes," complete Schedule D, Part IV 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasiendowments? If "Yes," complete Schedule D, Part V 11 If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X
as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? if "Yes," complete Schedule D,
Part VI
b 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
c Did the organization report an amount for investments • program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16? if "Yes," complete Schedule D, Part VIII
d 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
PartX, line 16? if "Yes," complete Schedule D, Part IX
e Did the organization report an amount for other liabilities in Part X, line 25? if "Yes," complete Schedule D, PartX
f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? if "Yes," complete Schedule D, PartX
12a Did the organization obtain separate, independent audited financial statements for the tax year? if "Yes,' complete
Schedule D, Parts XI and XII
b Was the organization included in consolidated, independent audited financial statements for the tax year?
If" Ves," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional
13 Is the organization a school described in section 170(b)(1)(A)(ii)? /f "yes/'comp/eteSchedu/ef
14a Did the organization maintain an office, employees, or agents outside of the United States?
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business,
investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000
or more? if "Yes," complete Schedule F, Parts I and IV 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization? if "Yes," complete Schedule F, Parts II and IV 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to
or for foreign individuals? if "Yes," complete Schedule F, Parts III and IV 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11 e? If "Yes," complete Schedule G, Part I 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a7 if "Yes," complete Schedule G, Part II 19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? ff "Yes,"
cnmnlete Schedule G. Pftrflll
9
10
1a
1b
1c
1d 1e
I f
2a
2b
4a
4b
Yes
X
X
X
X X
X
X
X
X
No
X
X
X
X
X
X
X X
X
X
X
X
Form 9 9 0 (2015)
532003 12-16-15
Form 990 (2015) RONALD MCDONALD HOUSE AT STANFORD | PartiV | Checklist of Required Schedules (continued)
9 4 - 2 5 3 8 6 1 5 Paae4
21
22
23
20a Did the organization operate one or more hospital facilities? if "Yes," complete Schedule H
b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line 1 ? If "Yes," complete Schedule I, Parts I and II
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 III Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees? if "Yes," complete
Schedule J 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 b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
25a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit
transaction with a disqualified person during the year? if "Yes," complete Schedule L, Part I
b 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 990-EZ? if "Yes," complete
Schedule L, Parti 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 II Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If "Yes," complete Schedule L, Part III Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV
instructions for applicable filing thresholds, conditions, and exceptions):
a A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, PartIV
b A family member of a current or former officer, director, trustee, or key employee? if "Yes," complete Schedule L, Part IV
c 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, PartIV
Did the organization receive more than $25,000 in non-cash contributions? if" Yes," complete Schedule M
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? if "Yes," complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Parti
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? if "Yes," complete
Schedule N, Part II
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I
Was the organization related to any tax-exempt or taxable entity? if "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)?
b 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 R, Part V, line 2
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization?
If "Yes," complete Schedule R, PartV, line 2 Did the organization conduct more than 5% of its activities through an entity that is not a related organization
and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, PartVI
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 b and 19?
Note. All Form 990 filers are required to complete Schedule O
26
27
28
29 30
31
32
33
34
36
37
38
20a
20b
21
22
23
24a
24b
24c
24d
25a
25b
26
27
28a
28b
28c
29
30
31
32
33
34
35a
35b
36
37
38
Yes
X
X
X
No
X
X
X
X
X
X
X
X
X X
X
X
X
X
X
X X
X
X
Form 9 9 0 (2015)
532004 12-16-15
Form 990 (2015) RONALD MCDONALD HOUSE AT STANFORD Part V | Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V
9 4 - 2 5 3 8 6 1 5 PaaeS
UL
l a
1b
2a
1a Enter the number reported in Box 3 of Form 1096. Enter-0- if not applicable
b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable
c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners?
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
filed for the calendar year ending with or within the year covered by this return
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines l a and 2a is greater than 250, you may be required to e-file (see instructions)
3a Did the organization have unrelated business gross income of $1,000 or more during the year?
b If "Yes," has it filed a Form 990-T for this year? if "No," to line 3b, provide an explanation in Schedule O
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)?
b If "Yes," enter the name of the foreign country: •
43
43
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
c If "Yes," to line 5a or 5b, did the organization file Form 8886-T?
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions?
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
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 provided to the payor?
b If "Yes," did the organization notify the donor of the value of the goods or services provided?
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
d If "Yes," indicate the number of Forms 8282 filed during the year | 7d I
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the N / A
sponsoring organization have excess business holdings at anytime during the year?
9 Sponsoring organizations maintaining donor advised funds.
a Did the sponsoring organization make any taxable distributions under section 4966? N/A
b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? N / A
10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 N / A
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
11 Section 501(cK12) organizations. Enter:
a Gross income from members or shareholders N / A
b Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041 ?
b If "Yes," enter the amount of tax-exempt interest received or accrued during the year N / A . . . | 12b I
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? N / A .
Note. See the instructions for additional information the organization must report on Schedule O.
b Enter the amount of reserves the organization is required to maintain by the states in which the
10a
10b
11a
11b
organization is licensed to issue qualified health plans
c Enter the amount of reserves on hand
14a Did the organization receive any payments for indoor tanning services during the tax year?
13b
13c
b If "Yes." has it filed a Form 720 to report these payments? if "Mn " nmwWp an exnlanatinn in fir.heriiilf> n
1c
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
12. 7h
9a
9b
12a
13a
14a
14b
Yes No
X X
N M N M
X
X
X
X X
X
Form 9 9 0 (2015)
532005 12-16-15
Form 990 (2015) RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Page'
| P a r t V l | G o v e r n a n c e , M a n a g e m e n t , a n d Disc losure Foreach "Yes" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this PartVl I X I
Section A. Governing Body and Management
1a
1b
1a Enter the number of voting members of the governing body at the end of the tax year
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee, explain in Schedule 0.
b Enter the number of voting members included in line 1a, above, who are independent
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other
officer, director, trustee, or key employee?
3 Did the organization delegate control over management duties customarily performed by or under the direct supervision
of officers, directors, or trustees, or key employees to a management company or other person?
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
5 Did the organization become aware during the year of a significant diversion of the organization's assets?
6 Did the organization have members or stockholders?
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or
more members of the governing body?
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a The governing body?
b Each committee with authority to act on behalf of the governing body?
9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the
organization's mailing address? If "Ves.' nmvirie the nftmex and addresses in Snheriule O
22
21
7a
7b
8a
8b
Yes
X
No
X
X X X X
X
X Section B. Policies (This Section B requests information about policies not required bv the Internal Revenue Code.)
10a Did the organization have local chapters, branches, or affiliates?
b If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent with the organization's exempt purposes?
1 l a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
b Describe in Schedule O the process, if any, used by the organization to review this Form 990.
12a Did the organization have a written conflict of interest policy? if "No," go to line 13
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
c Did the organization regularly and consistently monitor and enforce compliance with the policy? if "Yes," describe
in Schedule Ohowthis was done 13 Did the organization have a written whistleblower policy?
14 Did the organization have a written document retention and destruction policy?
15 Did the process for determining compensation of the following persons include a review and approval by independent
persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a The organization's CEO, Executive Director, or top management official
b Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year?
b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's
exempt status with respect to such arrangements?
10a
10b
11a
12a
12b
12c
13 14
15a
15b
16a
16b
Yes
X
X X
X X X
X
No
X
X
X
Section C. Disclosure 17 18
19
20
List the states with which a copy of this Form 990 is required to be filed • C A
Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
[ X ] Own website [ZH Another's website [ S Upon request d H Other (explain in Schedule O)
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial
statements available to the public during the tax year.
State the name, address, and telephone number of the person who possesses the organization's books and records: •
CYNTHIA SEMENOFF, DIRECTOR OF FINANCE - 650-470-6009 520 SAND HILL ROAD, PALO ALTO, CA 94304
532006 12-16-15 Form 9 9 0 (2015)
Form 990 (20151 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Paae7 | Part VU | 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 I I
Section A. Officers. Directors. Trustees, Key Employees, and Highest Compensated Employees la Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
• List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
• List all of the organization's current key employees, if any. See instructions for definition of "key employee." • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received report
able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. • List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of
reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization,
more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. I I Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A) Name and Title
( 1 ) ANNETTE EROS
CHIEF EXECUTIVE OFFICER
( 2 ) JANICE ROBERTS
PRESIDENT
( 3 ) SCOTT RODRICK
VICE PRESIDENT
( 4 ) JENNY CHANG
TREASURER
( 5 ) NELLIE LING
SECRETARY
( 6 ) DANIEL BERNSTEIN
DIRECTOR
( 7 ) GREGG DAVIS - TO 0 1 / 2 1 / 1 5
DIRECTOR
( 8 ) LAURIE LACOB
DIRECTOR
( 9 ) JIM MCCAUGHEY
DIRECTOR
( 1 0 ) DEBORAH MUELLER - TO 0 1 / 2 1 / 1 5
DIRECTOR
( 1 1 ) JULIA ERWIN-WEINER
DIRECTOR
( 1 2 ) BRAD LYMAN
PAST PRESIDENT
( 1 3 ) MICHAEL RUBENSTEIN
DIRECTOR
( 1 4 ) ALLISON LEOPOLD TILLEY
DIRECTOR
( 1 5 ) MIKE BANIC - TO 0 1 / 2 1 / 1 5
DIRECTOR
( 1 6 ) CYNTHIA LOPEZ BEVERAGE
DIRECTOR
( 1 7 ) ANDY KIRKPATRICK
DIRECTOR
(B) Average hours per
week (list any hours for related
organizations below line)
4 0 . 0 0
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
1 .00
(C) Position
(do not check more than one box, unless person is both an officer and a director/trustee) 2
•u
I ••&
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
1 i o
'= o
X
X
X
X
X
1 E
I
I E
II e
(D) Reportable
compensation from the
organization (W-2/1099-MISC)
1 7 3 , 2 3 5 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
(E) Reportable
compensation from related organizations
(W-2/1099-MISC)
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
(F) Estimated amount of
other compensation
from the organization and related
organizations
2 7 , 1 4 1 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 . 532007 12-16-15 Form 990 (2015)
Form 990 (2015> RONALD MCDONALD IPartVH
HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 PaqeS Section A. Officers. Directors, Trustees, Key Employees, and Highest Compensated Employees (continuer))
(A)
Name and title
( 1 8 ) MELINDA LITHERLAND
DIRECTOR
( 1 9 ) KAREN BOYD
DIRECTOR
( 2 0 ) HELEN WILMOT
DIRECTOR
( 2 1 ) BRAD O'BRIEN
DIRECTOR
( 2 2 ) CYNTHIA MAHOOD LEVIN
DIRECTOR
( 2 3 ) JEFF S I L K
DIRECTOR
( 2 4 ) DENISE COTE - TO 0 1 / 2 1 / 1 5
DIRECTOR
( 2 5 ) CHERYL CHENG
DIRECTOR
( 2 6 ) DAN FRANCIS
DIRECTOR
(B) Average
hours per week
(list any hours for related
organizations below line)
1 .00
1 .00
1 .00
1 . 0 0
1 .00
1 .00
1 .00
1 .00
1 .00
(C) Position
(do not check more than one box, unless person is both an officer and a director/trustee)
i
H I
1
X
X
X
X
X
X
X
X
X
i 1 s
o "5. E S1
i"
It 1
1b Sub-total •
c Total from continuation sheets to Part VII, Section A •
d Total (add lines lb and 1c) •
(D)
Reportable compensation
from the
organization (W-2/1099-MISC)
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 . 1 7 3 , 2 3 5 . 3 7 2 , 4 3 6 . 5 4 5 , 6 7 1 .
(E)
Reportable compensation from related organizations
(W-2/1099-MISC)
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 . 0 . 0 . 0 .
(F)
Estimated amount of
other compensation
from the organization and related
organizations
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 .
0 . 2 7 , 1 4 1 . 4 8 , 2 2 1 . 7 5 , 3 6 2 .
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from the organization •
Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
tone la? If "Yes," complete Schedule J for such individual For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,000? if "Yes," complete Schedule J for such individual
Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individual for services
rendered to the Organization? If "Vfts " nnmnlete KnheHulR ,1 fnr such nerxnn
3
4
L5_
Yes
X
No
X
X Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from
the organization. Report compensation for the calendar year ending with or within the organization's tax year.
(A) Name and business address
VANCE BROWN I N C . 3197 PARK B L V D . , PALO ALTO, CA 94306 CUSTOMIZED PERFORMANCE 1334 RIDDER PARK DR, SAN JOSE, CA 9 5 1 3 1 DATA MARKETING I N C . P . O . BOX 5 1 9 , SANTA CLARA, CA 95052
(B) Description of services
CONSTRUCTION MANAGEMENT
HOUSEKEEPING PRINTING AND MAIL ING SERVICES
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 • 3
(C) Compensation
1 6 2 , 9 9 1 .
1 0 3 , 1 0 3 .
1 0 0 , 0 2 4 .
532008 12-16-15
SEE PART VII, SECTION A CONTINUATION SHEETS Form 990 (2015)
Form 990 R O N A L D M C D O N A L D HOUSE AT STANFORD 94-2538615 [Pa r t VH Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees tcnntinuad)
(A) Name and title
( 2 7 ) CYNTHIA SEMENOFF
DIRECTOR OF FINANCE
( 2 8 ) LAURA BOUDREAU
COO
( 2 9 ) JAY MCCULLOUGH
CHIEF DEVELOPMENT OFFICER
(B)
Average hours
per week
(list any hours for related
organizations below line)
40.00
40.00
40.00
(C)
Position (check all that apply)
••5 o
1 1
X
1
s o E
H
E o
X
X
O
Total to Part VII, Section A, line 1c
(D)
Reportable compensation
from the
organization (W-2/1099-MISC)
105 ,766 .
134 ,807 .
131 ,863 .
372 ,436 .
(E) Reportable
compensation from related
organizations (W-2/1099-MISC)
0.
0.
0 .
(F)
Estimated amount of
other compensation
from the organization and related
organizations
1 6 , 9 2 9 .
1 5 , 3 6 7 .
15 ,925 .
4 8 , 2 2 1 .
Form 990 (2015) - - - - - - -g ---• | Part VIII | Statement of Revenue
RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Page'
Check if Schedule 0 contains a response or note to any line in this Part VIII
£#
H 0J
IS U^
?, o 'Fai <Si <e a
o £
c
I 4)
o
1 a Federated campaigns
b Membership dues
c Fundraising events
d Related organizations
e Government grants (contributions)
f All other contributions, gifts, grants, and
similar amounts not included above
g Noncash contributions included in lines la- l f : $
1a
1b
1c
1d
1e
1f
26,014.
598,485.
10,286,569.
1,248,057.
h Total. Add lines 1a-1f •
2 a PROGRAM SERVICE REV
b ROOM DONATIONS
C
d
e
f All other program service reve
a Total. Add lines 2a-2f
tue
Business Code 624100
624100
• 3 Investment income (including dividends, interest, and
other similar amounts) •
4 Income from investment of tax-exempt bond proceeds •
5 Royalties •
6 a Gross rents
b Less: rental expenses
c Rental income or (loss)
d Net rental income or (loss) ..
7 a Gross amount from sales of
assets other than inventory
b Less: cost or other basis
and sales expenses
c Gain or (loss)
(i)Real (ii) Personal
• (i) Securities 2,067,199.
2 ,064 ,321 .
2 ,878.
(ii) Other
d Net gain or (loss) •
8 a Gross income from fundraising events (not including $ 598,485. 0 f
contributions reported on line 1 c). See
Part IV, line 18
b Less: direct expenses
a
b
c Net income or (loss) from fundraising events
9 a Gross income from gaming activities. See
Part IV, line 19
b Less: direct expenses
c Net income or (loss) from gaming activities
10 a Gross sales of inventory, less returns
and allowances
b Less: cost of goods sold
a
b
a
b
c Net income or (loss) from sales of inventory ..
Miscellaneous Revenue H a OTHER INCOME
b
c
d All other revenue
e Total. Add lines 11 a-11 d
12 Total revenue. See instructions.
642,275.
616,856.
•
162,850.
83,633.
•
^ Business Code
624100
•
(A) Total revenue
10,911,068.
66,645.
53,773.
120,418.
502,582.
2,878.
25,419.
79,217.
11,813.
11,813.
11,653,395.
(B) Related or
exempt function revenue
> • . : • • ' ' ' : :
66,645.
53,773.
120,418.
(C) Unrelated business revenue
0.
• (D) Revenue excluded
from tax under sections 512-514
502,582.
2 ,878.
25,419.
79,217.
11,813.
621,909.
532009 12-16-15 Form 990 (2015)
Form 990 (2015) RONALD MCDONALD HOUSE AT STANFORD | Part IX | Statement of Functional Expenses
9 4 - 2 5 3 8 6 1 5 PaaelO
Section 501(c)(3) and 50Wc)M) organizations must complete all columns. All other organizations must complete column fA^). Check if Schedule 0 contains a response or note to anv line in this Part IX 1 1
Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.
1 Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
2 Grants and other assistance to domestic
individuals. See Part IV, line 22
3 Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16
4 Benefits paid to or for members
5 Compensation of current officers, directors,
trustees, and key employees
6 Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
7 Other salaries and wages
8 Pension plan accruals and contributions (include
section 401 (k) and 403(b) employer contributions)
9 Other employee benefits
10 Payroll taxes
11 Fees for services (non-employees):
a Management
b Legal
c Accounting
d Lobbying
e Professional fundraising services. See Part IV, line 17
f Investment management fees
g Other. (If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch 0.)
12 Advertising and promotion
13 Office expenses
14 Information technology
15 Royalties
16 Occupancy
17 Travel
18 Payments of travel or entertainment expenses
for any federal, state, or local public officials
19 Conferences, conventions, and meetings
20 Interest
21 Payments to affiliates .
22 Depreciation, depletion, and amortization
23 Insurance
24 Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule 0.)
a PRINTING AND SUPPLIES b PUBLIC RELATIONS & NEWS c DONOR ENGAGEMENT AND AC d OTHER e All other expenses
25 Total functional expenses. Add lines 1 through 24e
26 Joint costs. Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Check here ^ - | if following SOP 98-2 (ASC 958-720)
(A) Total expenses
3 2 3 , 0 7 1 .
1 , 4 1 5 , 8 3 1 .
4 2 , 3 2 1 . 163 ,175 . 142 ,227 .
1 4 , 7 9 9 . 3 8 , 5 3 9 .
8 1 , 9 4 9 .
286 ,870 .
34 ,475 . 4 3 , 5 9 6 .
388 ,388 . 1 4 , 3 1 6 .
2 6 , 8 6 2 .
441 ,509 . 37 ,623 .
' . . • :
811 ,250 . 6 5 , 2 4 1 . 4 2 , 8 4 7 . 32 ,340 .
9 , 3 3 8 . 4 , 4 5 6 , 5 6 7 .
(B) Program service
expenses
206 ,765 .
906 ,132 .
27 ,085 . 104 ,433 .
91 ,025 .
9 , 4 7 1 .
182 ,717 .
2 8 , 3 6 1 . 2 7 , 9 0 2 .
376 ,963 . 9 ,163 .
1 7 , 1 2 3 .
428 ,484 . 36 ,495 .
' • • • ' . : ' • '
627 ,857 . 38 ,497 .
9 ,614 . 8 ,503 .
3 , 1 3 6 , 5 9 0 .
(C) Management and general expenses
45 ,230 .
198 ,216 .
5 ,925 . 22 ,844 . 19 ,912 .
2 , 0 7 2 . 38 ,539 .
81 ,949 .
32 ,032 .
2 , 5 3 2 . 6 ,103 .
7 ,617 . 2 , 0 0 4 .
3 ,853 .
8 ,683 . 752.
11 ,094 . 7 ,768 .
9 ,906 . 3 0 1 .
507 ,332 .
(D) Fundraising expenses
71 ,076 .
311 ,483 .
9 , 3 1 1 . 35 ,898 . 31 ,290 .
3 ,256 .
7 2 , 1 2 1 .
3 ,582 . 9 , 5 9 1 .
3 ,808 . 3 ,149 .
5 ,886 .
4 , 3 4 2 . 376.
172 ,299 . 18 ,976 . 4 2 , 8 4 7 . 1 2 , 8 2 0 .
534. 812 ,645 .
532010 12-16-15 Form 990 (2015)
Form 990 (20151 | Part X | Balance Sheet
RONALD MCDONALD HOUSE AT STANFORD 94-2538615 PaaeH
Check if Schedule 0 contains a response or note to anv line in this Part X
Si s <
OT 0
« - 1
M
Ji m
CD • o
u.
1 (0
•5 < Z
1
2
3
4
5
6
7
8
9
10a
b
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
Cash - non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
Accounts receivable, net
Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L
Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501(c)(9) voluntary
employees' beneficiary organizations (see instr). Complete Part II of Sch L
Notes and loans receivable, net
Inventories for sale or use
Prepaid expenses and deferred charges
Land, buildings, and equipment: cost or other
basis. Complete Part VI of Schedule D
Less: accumulated depreciation
10a
10b
4 0 , 4 3 1 , 9 5 0 . 6 , 2 2 9 , 3 8 0 .
Investments - publicly traded securities
Investments - other securities. See Part IV, line 1
Investments - program-related. See Part IV, line 1
Intangible assets
1
1
Other assets. See Part IV, line 11
Total assets. Add lines 1 throuoh 15 (must equal line 34}
Accounts payable and accrued expenses
Grants payable
Deferred revenue
Tax-exempt bond liabilities
Escrow or custodial account liability. Complete Part IV
Loans and other payables to current and former officer
key employees, highest compensated employees, and
of Schedule D
s, directors, taistees,
disqualified persons.
Complete Part II of Schedule L
Secured mortgages and notes payable to unrelated thi
Unsecured notes and loans payable to unrelated third |
Other liabilities (including federal income tax, payables
parties, and other liabilities not included on lines 17-24)
Schedule D
rd parties
Darties
to related third
. Complete Part X of
Total liabilities. Add lines 17 through 25 .... . . . .
Organizations that follow SFAS 117 (ASC 958), check here • I X J and
complete lines 27 through 29, and lines 33 and 34.
Unrestricted net assets
Temporarily restricted net assets
Permanently restricted net assets
Organizations that do not follow SFAS 117 (ASC 958), check here • I J
and complete lines 30 through 34.
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or eqi jipmer
Retained earnings, endowment, accumulated income, <
Total net assets or fund balances
it fund
ar other funds
Total liabilities and net assets/fund balances
(A) Beginning of year
6 , 1 4 6 , 2 2 8 . 9 , 6 6 5 , 4 1 1 . 3 , 1 1 3 , 3 1 2 .
106 ,746 .
1 7 , 2 8 9 , 8 5 6 . 1 7 , 7 1 9 , 1 6 1 .
2 2 , 5 0 5 , 4 2 4 . 7 6 , 5 4 6 , 1 3 8 .
641 ,816 .
638 ,088 . 1 ,279 ,904 .
2 5 , 6 0 4 , 6 5 7 . 4 0 , 4 7 7 , 0 4 0 .
9 , 1 8 4 , 5 3 7 .
7 5 , 2 6 6 , 2 3 4 . 7 6 , 5 4 6 , 1 3 8 .
1
2
3
4
5
6
7
8
9
10c
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
- 2 6 ,
27
28
29
30
31
32
33
34
IX| (B)
End of year
1 0 , 9 6 0 , 8 9 5 . 1 ,249 ,327 . 7 , 5 9 5 , 9 2 2 .
• : • : -: • J
3 6 6 , 3 6 1 .
3 4 , 2 0 2 , 5 7 0 . 1 6 , 9 8 5 , 0 9 2 .
2 2 , 3 6 6 , 8 4 2 . 9 3 , 7 2 7 , 0 0 9 .
2 , 7 3 6 , 3 7 8 .
7 , 4 7 3 , 0 0 0 .
2 , 0 9 3 , 3 3 9 . 1 2 , 3 0 2 , 7 1 7 .
3 3 , 9 9 3 , 2 1 0 . 3 8 , 1 9 3 , 2 0 8 .
9 , 2 3 7 , 8 7 4 .
8 1 , 4 2 4 , 2 9 2 . 9 3 , 7 2 7 , 0 0 9 .
Form 990 (2015)
532011 12-16-15
Form 990 (20151 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Paae12 | Part XI | Reconciliation of Net Assets
Check if Schedule 0 contains a response or note to anv line in this Part XI
1 Total revenue (must equal Part VIII, column (A), line 12)
2 Total expenses (must equal Part IX, column (A), line 25)
3 Revenue less expenses. Subtract line 2 from line 1
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
5 Net unrealized gains (losses) on investments
6 Donated services and use of facilities
7 Investment expenses
8 Prior period adjustments
9 Other changes in net assets or fund balances (explain in Schedule 0)
10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
u 1
2
3
4
5
6
7
8
9
10
1 1 , 6 5 3 , 3 9 5 . 4 , 4 5 6 , 5 6 7 . 7 , 1 9 6 , 8 2 8 .
7 5 , 2 6 6 , 2 3 4 . - 9 0 0 , 1 8 7 . - 1 3 8 , 5 8 3 .
0 .
8 1 , 4 2 4 , 2 9 2 . j Part XH| Financial Statements and Reporting
Check if Schedule O contains a response or note to anv line in this Part XII 5 ]
1 Accounting method used to prepare the Form 990: I I Cash 1 X I Accrual 1 I Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
2a Were the organization's financial statements compiled or reviewed by an independent accountant?
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
I 1 Separate basis I I Consolidated basis I I Both consolidated and separate basis
b Were the organization's financial statements audited by an independent accountant?
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis, or both:
1 X 1 Separate basis 1 1 Consolidated basis I I Both consolidated and separate basis
c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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?
b 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 O and describe anv steps taken to undergo such audits
2a
2b
2c
3a
3b
Yes No
X
X
X
Form 9 9 0 (2015)
532012 12-16-15
SCHEDULE A (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust. • Attach to Form 990 or Form 990-EZ.
• Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.aov/form990. Name of the organization
RONALD MCDONALD HOUSE AT STANFORD
OMB No. 1545-0047
2015 Open to Public ; i; •; Inspection
Employer identification number
94-2538615 i ) | a | | ; | | | R e a s o n for Publ ic Char i ty S ta tus (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1 I I A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2 CZ I A school described in section 170{b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)
3 I I A hospital or a cooperative hospital service organization described in section 170(bX1)(AXiii).
4 I I A medical research organization operated in conjunction with a hospital described in section 170(bX1)(A)(iii). Enter the hospital's name,
city, and state:
5 I I An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(bX1XA)(iv). (Complete Part II.)
6 I I A federal, state, or local government or governmental unit described in section 170(bX1)(A)(v).
7 I X I An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
section 170(bX1XA)(vi). (Complete Part II.)
8 I I A community trust described in section 170(bX1)(A)(vi). (Complete Part II.)
9 I I An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from
activities related to its exempt functions • subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30,1975.
See section 509(a)(2). (Complete Part 111.)
10 I I An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
11 I I An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in
lines 11a through l i d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.
a I I Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving
the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting
organization. You must complete Part IV, Sections A and B.
b I I Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having
control or management of the supporting organization vested in the same persons that control or manage the supported
organization(s). You must complete Part IV, Sections A and C.
c I I Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.
d I I Type III non-functionally integrated. A supporting organization operated in connection with its supported organization^)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
e I I Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III
functionally integrated, or Type III non-functionally integrated supporting organization.
f Enter the number of supported c
g Provide the followinq informatior (i) Name of supported
organization
Total
rqanizations r i i about the supported orqanization(s).
(ii) EIN (iii) Type of organization (described on lines 1-9
above (see instructions))
(iv) Is the organization listed in your
governing document? Yes No
(v) Amount of monetary support (see instructions)
(vi) Amount of other support (see
LHA For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ. 532021 09-23-15
Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-EZ) 2015 RONALD MCDONALD HOUSE AT STANFORD Schedule A (Form 990 or 990 EZ) 2015 KUaiALU MCDONALD HUUSM AT HTAMFUKD r.T " . - ? . : Part I I I Support Schedule for Organizations Described in Sections l70(bj(l)(A)(iv) and l70{b)(1)(A}(vi;
9 4 - 2 5 3 8 6 1 5 Paae2
(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 fails to qualify under the tests listed below, please complete Part III.)
I. If the organization
Section A. Public Support Calendar year (or fiscal year beginning in) •
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.")
2 Tax revenues levied for the organ
ization's benefit and either paid to
or expended on its behalf
3 The value of services or facilities
furnished by a governmental unit to
the organization without charge
4 Total. Add lines 1 through 3
5 The portion of total contributions
by each person (other than a
governmental unit or publicly
supported organization) included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f)
6 Public SUDDOrt. Subtract line 5 from line 4
(a) 2011
4220260.
4220260.
(b)2012
4690791.
4690791.
(c)2013
3962692.
3962692.
. ' • • • ' " '
(d)2014
8688873.
8688873.
fe) 2015
10911068.
10911068.
(f) Total
32473684.
32473684.
4220457. 28253227.
Section B. Total Support Calendar year (or fiscal year beginning in) •
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 business
activities, whether or not the
business is regularly carried on
10 Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part VI.)
11 Total support. Add lines 7 through 10
12 Gross receipts from related activities,
(a) 2011
4220260.
505 ,580 .
6 , 830 .
etc. (see instructic
(b)2012
4690791.
566 ,142 .
6 , 493 .
(c)2013 3962692.
679 ,367 .
6 ,949 .
(d)2014
8688873.
527 ,242 .
6 ,915 .
>ns)
(e)2015
10911068.
502 ,582 .
11 ,813 .
(f) Total
32473684.
2780913.
3 9 , 0 0 0 . 35293597.
12 4 , 0 9 8 , 3 6 2 . 13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
organization, check this box and stop here Section C. Computation of Public Support Percentage ±u.
14 15
14 Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f))
15 Public support percentage from 2014 Schedule A, Part II, line 14
16a 33 1/3% support test - 2015. If the organization did not check the box on line 13, and line 14 is 331/3% or more, check this box and
stop here. The organization qualifies as a publicly supported organization
b 33 1/3% support test - 2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
17a 10% -facts-and-circumstances test - 2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more;
and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
b 10% -facts-and-circumstances test - 2014. If the organization did not check a box on line 13,16a, 16b, or 17a, and line 15 is 10% or
more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
18 Private foundation. If the organization did not check a box on line 13.16a. 16b. 17a. or 17b. check this box and see instructions
8 0 . 0 5 % 82.63 %
• •
• •
±L1 Schedule A (Form 990 or 990-EZ) 2015
532022 09-23-15
Schedule A (Form 990 or 990-Ea 2015 RONALD MCDONALD HOUSE AT STANFORD | Part ill | Support Schedule for Organizations Described in Section 509(a)(2)
9 4 - 2 5 3 8 6 1 5 paoe3
(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 fiscal year beginning in) •
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.")
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3 Gross receipts from activities that are not an unrelated trade or business under section 513
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf
5 The value of services or facilities furnished by a governmental unit to the organization without charge
6 Total. Add lines 1 through 5 7a Amounts included on lines 1, 2, and
3 received from disqualified persons b 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
c Add lines 7a and 7b 8 Public SUDDOrt. (Subtract line 7c from line 6.)
(a) 2011 (b)2012 (c)2013 (€02014 (e)2015 If) Total
Section B. Total Support Calendar year (or fiscal year beginning in) •
9 Amounts from line 6 10a Gross income from interest,
dividends, payments received on securities loans, rents, royalties and income from similar sources
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30,1975
c Add lines 10a and 10b 11 Net income from unrelated business
activities not included in line 10b, whether or not the business is regularly 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, 11, and 12.)
(a) 2011 (b)2012 (c)2013 (d)2014 (e)2015 (f) Total
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization, check this box and stop here JfcO.
Section C. Computation of Public Support Percentage 15 Public support percentage for 2015 (line 8, column (f) divided by line 13, column i 16 Public support percentage from 2014 Schedule A. Part III, line 15
15 16
Section D. Computation of Investment Income Percentage 17 18
17 Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (1)) 18 Investment income percentage from 2014 Schedule A, Part III, line 17 19a 33 1/3% support tests - 2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not
more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization • I I b 33 1/3% support tests - 2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and
line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization • I I 20 Private foundation. If the organization did not check a box on line 14.19a. or 19b. check this box and see instructions • ! J 532023 09-23-15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-Ea 2015 RONALD MCDONALD HOUSE AT STANFORD | Part IV j Supporting Organizations
(Complete only if you checked a box in line 11 on Part I. If you checked 11 a of Part I, complete Sections A
and B. If you checked 11 b of Part I, complete Sections A and C. If you checked 11 c of Part I, complete
Sections A, D, and E. If you checked l i d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations
9 4 - 2 5 3 8 6 1 5 PaQe4
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. If designated by
class or purpose, describe the designation. If historic and continuing relationship, explain. 2 Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)7 if "Yes," explain in Part VI how the organization determined that the supported
organization was described in section 509(a)(1) or (2).
3a Did the organization have a supported organization described in section 501 (c)(4), (5), or (6)? if "Yes," answer
Q>) and (c) below.
b 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. c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)
purposes? if "Yes," explain in Part VI what controls the organization put in place to ensure such use. 4a Was any supported organization not organized in the United States ("foreign supported organization")? if
"Yes," and if you checked 11a or 11 b in Part I, answer (b) and (c) below. b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization? if "Yes," describe in Part VI how the organization had such control and discretion
despite being controlled or supervised by or in connection with its supported organizations. c Did the organization support any foreign supported organization that does not have an IRS determination
under sections 501(c)(3) and 509(a)(1) or (2)? if "Yes," explain in Part VI what controls the organization used
to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)
purposes.
5a Did the organization add, substitute, or remove any supported organizations during the tax year? if "Yes,"
answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and BIN
numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;
(lii) the authority under the organization's organizing document authorizing such action; and (iv) how the action
was accomplished (such as by amendment to the organizing document). b Type I or Type II only. Was any added or substituted supported organization part of a class already
designated in the organization's organizing document?
c Substitutions only. Was the substitution the result of an event beyond the organization's control?
6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to
anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class
benefited by one or more of its supported organizations, or (iii) other supporting organizations that also
support or benefit one or more of the filing organization's supported organizations? if "Yes," provide detail in
Part VI.
7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor
(defined in section 4958(cK3)(C)), a family member of a substantial contributor, or a 35% controlled entity with
regard to a substantial contributor? if "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ). 9a Was the organization controlled directly or indirectly at any time during the tax year by one or more
disqualified persons as defined in section 4946 (other than foundation managers and organizations described
in section 509(a)(1) or (2))? if "Yes," provide detail in Part VI.
b 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.
c 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.
10a Was the organization subject to the excess business holdings rules of section 4943 because of section
4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated
supporting organizations)? if "Yes," answer 70b below.
b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to
determine whether tho nmaniratinn hari pyrffss hnsinfiss hnlHinas \
3a
3b
3c
4a
4b
4c
5a
5b 5c
9a
9b
9c
10a
10b
Yes No
532024 09-23-15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-Ea 2015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 PaaeS Part IV | Supporting Organizations (continued)
11 Has the organization accepted a gift or contribution from any of the following persons?
a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)
below, the governing body of a supported organization?
b A family member of a person described in (a) above?
c A 35% controlled entity of a person described in (a) or (b) above? if "Yes" to a. b. or c. provide detail in Part VI.
11a 11b 11c
Yes No
Section B. Type I Supporting Organizations
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 ail times during the
tax year? if "No," describe in Part VI how the supported organizations) effectively operated, supervised, or
controlled the organization's activities. If the organization had more than one supported organization,
describe how the powers to appoint and/or remove directors or trustees were allocated among the supported
organizations and what conditions or restrictions, if any, applied to such powers during the tax year. Did the organization operate for the benefit of any supported organization other than the supported
organization^) 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 organizations) that operated,
supervised, or contrnlleri the supporting nrganizatinn.
Yes No
Section C. Type II Supporting Organizations
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^)? if "No," describe in Part VI how control
or management of the supporting organization was vested in the same persons that controlled or managed the simnnrted nm?,ni7atinn(s)
Yes No
Section D. All Type III Supporting Organizations
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the
organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax
year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the
organization's governing documents in effect on the date of notification, to the extent not previously provided?
Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported
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 organizations). By reason of the relationship described in (2), did the organization's supported organizations have a
significant voice 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 plaved in this regard.
Yes No
Section E. Type III 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 I I The organization satisfied the Activities Test. Complete line 2 below.
b I 1 The organization is the parent of each of its supported organizations. Complete line 3 below.
c L Z I The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).
2 Activities Test. Answer (a) and (b) below.
a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of
the supported organization^) to which the organization was responsive? if "Yes," then in Part VI identify
those supported organizations and explain how these activities directly furthered their exempt purposes,
how the organization was responsive to those supported organizations, and how the organization determined
that these activities constituted substantially all of its activities. b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more
of the organization's supported organization(s) would have been engaged in? if "Yes," explain in Part VI the
reasons for the organization's position that its supported organizations) would have engaged in these
activities but for the organization's involvement.
3 Parent of Supported Organizations. /Answer (a) and (b) below.
a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or
trustees of each of the supported organizations? Provide details in Part VI.
b 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 Pprf VI the* rote nlaveri hv the nmanvatinn in this mnard
2a
2b
3a
3b
Yes No
532025 09-23-15 Schedule A (Form 990 or 990-EZ) 2015
Schedule A (Form 990 or 990-EZ) 2015 R O N A L D M C D O N A L D H O U S E A T STANFORD 9 4 - 2 5 3 8 6 1 5 Paaee [Part V LType III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1 I J Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20,1970. See instructions. All
other Type III nonfunctionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income
1 Net short-term capital qain
2 Recoveries of prior-year distributions
3 Other gross income (see instructions)
4 Add lines 1 through 3
5 Depreciation and depletion
6 Portion of operating expenses paid or incurred for production or
collection of gross income or for management, conservation, or
maintenance of property held for production of income (see instructions)
7 Other expenses (see instructions)
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)
1
2
3
4
5
6
7
8
Section B - Minimum Asset Amount
1 Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
a Average monthly value of securities
b Averaqe monthly cash balances
c Fair market value of other non-exempt-use assets
d Total (add lines l a , 1b, and 1c)
e Discount claimed for blockage or other
factors (explain in detail in Part VI):
2 Acquisition indebtedness applicable to non-exempt-use assets
3 Subtract line 2 from line 1 d
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)
(A) Prior Year
(A) Prior Year
1a
1b
1c
1d
2
3
4
5
6
7
8
Section C - Distributable Amount
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)
1
2
3
4
5
6
(B) Current Year (optional)
(B) Current Year (optional)
Current Year
7 I J Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see
instructions).
Schedule A (Form 990 or 990-EZ) 2015
532026 09-23-15
Schedule A Form 990 or 990-Ea 2015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Paae7 | Party | Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Section D - Distributions
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported
orqanizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported orqanizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions.
7 Total annual distributions. Add lines 1 throuqh 6.
8 Distributions to attentive supported organizations to which the organization is responsive
(provide details in Part VI). See instructions.
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided bv Line 9 amount
Section E - Distribution Allocations (see instructions)
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required-see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013
e From 2014
f Total of lines 3a throuqh e
q Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3q, 3h, and 3i from 3f.
4 Distributions for 2015 from Section D,
line 7: $
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if
any. Subtract lines 3g and 4a from line 2 (if amount
qreaterthan zero, see instructions).
6 Remaining underdistributions for 2015. Subtract lines 3h
and 4b from line 1 (if amount greater than zero, see
instructions).
7 Excess distributions carryover to 2016. Add lines 3j
and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013
d Excess from 2014
e Excess from 2015
<i) Excess Distributions
(«) Underdistributions
Pre-2015
Current Year
(Hi) Distributable
Amount for 2015
.•. = • : •'. •" :,-
Schedule A (Form 990 or 990-EZ) 2015
532027 09-23-15
Schedule A (Form 990 or 990-EZ) 2015 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 PaaeS Part VI Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12;
Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1 c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1 e; 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.)
532028 09-23-15 Schedule A (Form 990 or 990-EZ) 2015
** PUBLIC DISCLOSURE COPY **
Schedule B (Form 990,990-EZ, or 990-PF) Department of the Treasury Internal Revenue Service
Schedule of Contributors • Attach to Form 990, Form 990-EZ, or Form 990-PF.
• Information about Schedule B (Form 990,990-EZ, or 990-PF) and its instructions is at mw./rs.qov/fom7990 •
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD
OMB No. 1545-0047
2015 Employer identification number
94-2538615 Organization type (check one):
Filers of: Section:
Form 990 or 990-EZ I X I 501 (c)( 3 ) (enter number) organization
I I 4947(a)(1) nonexempt charitable trust not treated as a private foundation
I 1 527 political organization
Form 990-PF I I 501 (c)(3) exempt private foundation
I I 4947(a)(1) nonexempt charitable trust treated as a private foundation
I I 501 (c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
I I For an organization filing Form 990,990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
Special Rules
I X I For an organization described in section 501 (c)(3) filing Form 990 or 990-EZ that met the 33 1 /3% support test of the regulations under
sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13,16a, or 16b, and that received from
any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h,
or (ii) Form 990-EZ, line 1. Complete Parts I and II.
I I For an organization described in section 501 (c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
I I For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box
is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc.,
purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc., contributions totaling $5,000 or more during the year • $
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),
but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to
certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990,990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
RONALD MCDONALD HOUSE AT STANFORD
Employer identification number
94-2538615
Parti
(a) No.
1
(a) No.
2
(a) No.
3
(a) No.
4
(a) No.
5
(a) No.
6
Contr ibutors (see instructions). Use duplicate copies of Part 1 if additional space is needed.
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(c) Total contributions
$ 251 ,000 .
(c) Total contributions
$ 339 ,053 .
(c) Total contributions
$ 843 ,500 .
(c) Total contributions
$ 1 ,026 ,350 .
(c) Total contributions
$ 2 , 0 3 5 , 0 3 0 .
(c) Total contributions
$ 3 , 0 1 0 , 0 0 0 .
(d) Type of contribution
Person 1 X 1
Payroll | | Noncash | |
(Complete Part II for noncash contributions.)
(d) Type of contribution
Person U L l Payroll | | Noncash | J
(Complete Part II for noncash contributions.)
(d) Type of contribution
Person 1 X 1
Payroll | I Noncash | |
(Complete Part II for noncash contributions.)
(d) Type of contribution
Person 1 X 1
Payroll | | Noncash | |
(Complete Part II for noncash contributions.)
(d) Type of contribution
Person U D
Payroll | I Noncash | |
(Complete Part II for noncash contributions.)
(d) Type of contribution
Person 1 X 1 Payroll | | Noncash |
(Complete Part II for noncash contributions.)
523452 10-26-15 Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 3
Name of organization
RONALD MCDONALD HOUSE AT STANFORD
Employer identification number
94-2538615
Paitll
(a) No.
from Part i
(a) No.
from Par t i
(a) No.
from Part i
(a) No.
from
Part i
(a) No.
from Part i
(a) No.
from Part i
N o n c a s h Proper ty (see instructions). Use duplicate copies of Part II if additional space is needed.
(b) Description of noncash property given
(b) Description of noncash property given
(b) Description of noncash property given
(b) Description of noncash property given
(b) Description of noncash property given
(b) Description of noncash property given
(c) FMV (or estimate) {see instructions)
$
(c) FMV (or estimate) (see instructions)
$
(c) FMV (or estimate) (see instructions)
$
(c) FMV (or estimate) (see instructions)
$
(c) FMV (or estimate) (see instructions)
$
(c) FMV (or estimate) (see instructions)
$
(d) Date received
(d) Date received
(d) Date received
(d) Date received
(d) Date received
(d) Date received
523453 10-26-15 Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or990-PF) (2015) Page 4
Name of organization
RONALD MCDONALD HOUSE AT STANFORD
Employer identification number
94-2538615 P a r t 111 | Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for
the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations
(a) No. from Parti
(a) No. from Parti
(a) No. from Parti
(a) No. from Parti
completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this into, once.) ^ v
Use duplicate cooies of Part III if additional soace is needed.
(b) Purpose of gift (c) Use of gift
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(b) Purpose of gift
(d) Description of how gift is held
Relationship of transferor to transferee
(c) Use of gift
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(b) Purpose of gift
(d) Description of how gift is held
Relationship of transferor to transferee
(c) Use of gift
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(b) Purpose of gift
(d) Description of how gift is held
Relationship of transferor to transferee
(c) Use of gift
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(d) Description of how gift is held
Relationship of transferor to transferee
523454 10-26-15 Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
SCHEDULE D (Form 990)
Department of the Treasury Internal Revenue Service
Supplemental Financial Statements • Complete if the organization answered "Yes" on Form 990,
Part IV, line 6 ,7 ,8 ,9 ,10,11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b. • Attach to Form 990.
• Information about Schedule D (Form 990) and its instructions is at www irftanv/fnrmQQn
OMB No. 1545-0047
2015 upm to PUDtic Inspection
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615 Part 1 | Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts, complete if the
organization answered "Yes" on 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
(a) Donor advised funds (b) 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? I 1 Yes I I No
Did 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 benefit? ._,_,.., ^ | Yes I I No | P a r t H 1 Conserva t ion E a s e m e n t s . 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).
I I Preservation of land for public use (e.g., recreation or education) I I Preservation of a historically important land area
I I Protection of natural habitat I I Preservation of a certified historic structure
I I Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
2a
2b
2c
day of the tax year.
a Total number of conservation easements
b Total acreage restricted by conservation easements
c Number of conservation easements on a certified historic structure included in (a)
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register
i Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax
year •
Number of states where property subject to conservation easement is located •
2d
Held at the End ol the Tax Year
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? I I Yes I I No
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
• $ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)
and section 170(h)(4)(B)(ii)? • Yes • No
9 In Part XIII, 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 III | 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 XIII,
the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116 (ASC 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 service, provide the following amounts
relating to these items:
(i) Revenue included on Form990, Part VIII, l inel • $
(ii) Assets included in Form 990, PartX • $
2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide
the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a Revenue included on Form 990, Part VIII, line 1 • $
b Assets included in Form 990. Part X • $
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. 532051 11-02-15
Schedule D (Form 990) 2015
RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Paae2 Schedule D (Form 990) 2015 | Part III j Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets rconf/nued)
3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a I I Public exhibition d I I Loan or exchange programs b I I Scholarly research e I I Other c I I Preservation for future generations
4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. 5 During the year, did the organization solicit 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? I I Yes Part iV j 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 included on Form 990, Part X? d H Yes
b If "Yes," explain the arrangement in Part XIII and complete the following table:
c Beginning balance d Additions during the year e Distributions during the year f Ending balance
F I N O
• No
1c
1d
1e
I f
Amount
2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? i I Yes b If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII
I Part V \ Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10
• No
1a Beginning of year balance
b Contributions
c Net investment earnings, gains, and losses
d Grants or scholarships
e Other expenditures for facilities
and programs
f Administrative expenses
g End of year balance
(a) Current year 17,677,407.
53,337.
-422,459.
17,308,285.
(b) Prior year 17,753,760.
35,929.
987,094.
1,099,376.
17,677,407.
(c) Two years back 15,782,193.
40,957.
1,930,610.
17,753,760.
(d) Three years back 14,125,710.
39,110.
1,617,373.
15,782,193.
(e) Four years back 14,505,394.
93,166.
-472,850.
14,125,710.
2 Provide the estimated percentage of the current year end balance (line 1 g, column (a)) held as: a Board designated or quasi-endowment • % b Permanent endowment • 53 . 3 7 % c Temporarily restricted endowment • 4 6 » 6 3 %
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: (i) unrelated organizations (ii) related organizations
b If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part VI j Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
3a(i)
3a(ii)
3b
Yes No X X
Description of property
1a Land
b Buildings
c Leasehold improvements
d Equipment
e Other
Total. Add lines lathrouah 1e. (Cnhimn
(a) Cost or other basis (investment)
(b) Cost or other basis (other)
1 7 , 1 8 4 , 7 6 2 .
3 2 6 , 5 8 1 . 2 2 , 9 2 0 , 6 0 7 .
(c) Accumulated depreciation
5 , 9 8 4 , 0 7 8 .
245 ,302 .
*
(d) Book value
1 1 , 2 0 0 , 6 8 4 .
81 ,279 . 2 2 , 9 2 0 , 6 0 7 . 3 4 , 2 0 2 , 5 7 0 .
Schedule D (Form 990) 2015
532052 09-21-15
Schedule D (Form 990) 2015 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Paae3 | Part Vlt] Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line l i b . See Form 990, Part X, line 12. (a) Description Of Security Or Category (including name of security)
(1) Financial derivatives
(2) Closely-held equity interests
(3) Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Col. (b) must eaual Form 990. Part X. col. (B) line 12.) •
(b) Book value (c) Method of valuation: Cost or end-of-year market value
I | Part Villi Investments - Program Related.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13. (a) Description of investment (b) Book value (c) Method of valuation: Cost or end-of-year market value
ilL J2L (3)
J4L J5L M. JZL (8)
M. Total. (Col, (b) must equal Form 990. Part X. col. (B) line 13.' | Part IX | Other Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11 d. See Form 990, Part X, line 15. (a) Description
(D LEASE CONTRIBUTION RECEIVABLE RELATED TO DONATED RENT (2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(b) Book value
2 2 , 3 6 6 , 8 4 2 .
2 2 , 3 6 6 . 8 4 2 .
Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25. 1. (a) Description of liability
(1) Federal income taxes
(2) ACCRUED EXPENSES (3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column <b) must eaual Form 990. Part X. col. (B) line 25.) •
(b) Book value
2 , 0 9 3 , 3 3 9 .
2 , 0 9 3 , 3 3 9 .
' " " " • '. ';"-.': ::' ^ '-v :-'-
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial 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 provided in Part XIII I X I
Schedule D (Form 990) 2015
532053 09-21-15
Schedule D (Form 990) 2015 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Paae4 IFart XI%\ 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, gains, and other support per audited financial statements
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments
b Donated services and use of facilities
c Recoveries of prior year grants
d Other (Describe in Part XIII.)
2a
2b
2c
2d
- 9 0 0 , 1 8 7 . 1 ,888 ,009 .
618 ,540 . e Add lines 2a through 2d
3 Subtract line 2e from line 1
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b
b Other (Describe in Part XIII.)
4a
4b 363 ,070 . c Add lines 4a and 4b
5 Total revenue. Add lines 3 and 4^. flftfc m»fif flfflffrf Pnrm W Part /, fffffi 7P,) ,•••„••
1
2e
3
4c
_ 2 -
1 2 , 8 9 6 , 6 8 7 .
1 ,606 ,362 . 1 1 , 2 9 0 , 3 2 5 .
363 ,070 . 1 1 , 6 5 3 , 3 9 5 .
| Part XII | Reconciliation of Expenses per Audited Financial Statements With Expenses per Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Return.
1 Total expenses and losses per audited financial statements
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities
b Prior year adjustments
c Other losses
d Other (Describe in Part XIII.)
e Add lines 2a through 2d
2a
2b
2c
2d
2 , 0 2 6 , 5 9 2 .
337 ,419 .
3 Subtract line 2e from line 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 VIII, line 7b
b Other (Describe in Part XIII.)
4a
4b 81 ,949 . c Add lines 4a and 4b
_5 Total expenses. Add lines 3 and 4c. (This must ennnl Form <&() Part 1 tine 1R)
1
2e
3
4c
5
6 , 7 3 8 , 6 2 9 .
2 , 3 6 4 , 0 1 1 . 4 , 3 7 4 , 6 1 8 .
81 ,949 . 4 , 4 5 6 . 5 6 7 .
Part Xlll| Supplemental Information Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines la and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI,
lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
PART V, LINE 4;
THE HOUSE'S ENDOWMENT CONSISTS OF DONOR RESTRICTED FUNDS ESTABLISHED FOR
THE BENEFIT OF THE HOUSE. ALL ENDOWMENT GIFTS STIPULATE THAT THE
PRINCIPAL REMAIN INTACT AND THAT INVESTMENT EARNINGS BE EXPENDED ON HOUSE
OPERATIONS. THE HOUSE HAS A POLICY THAT PROVIDES THE BOARD OF DIRECTORS
THE DISCRETION TO SPEND UP TO 4.5% OF THE THREE YEAR ROLLING AVERAGE OF
THE ACTUAL FUND'S VALUE. IN ESTABLISHING THIS POLICY, THE HOUSE
CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT. ACCORDINGLY,
OVER THE LONG TERM, THE HOUSE EXPECTS THE CURRENT SPENDING POLICY TO ALLOW
ITS ENDOWMENT TO GROW AT AN AVERAGE OF 3% ANNUALLY. THIS IS CONSISTENT
WITH THE ORGANIZATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF THE
ENDOWMENT ASSETS HELD IN PERPETUITY AS WELL AS TO PROVIDE ADDITIONAL REAL Schedule D (Form 990) 2015
532054 09-21-15
ScheduleD(Form99012015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Pages |Paft XHl | Supplemental Information (continued)
GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN. THE HOUSE DID NOT
APPROPRIATE ANY EARNINGS DURING THE YEAR ENDED DECEMBER 31, 2015,
SUBSEQUENTLY IN JANUARY 2016, THE BOARD OF DIRECTORS APPROPRIATED $450,000
OF ENDOWMENT EARNINGS FOR USE IN OPERATIONS IN ACCORDANCE WITH THE
SPENDING POLICY OUTLINED ABOVE.
PART X, LINE 2:
THE HOUSE EVALUATED ITS CURRENT TAX POSITIONS AND HAS CONCLUDED THAT AS OF
DECEMBER 31, 2015, THE HOUSE DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX
POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:
SPECIAL EVENT EXPENSE 700,489.
INVESTMENT MANAGEMENT FEE -81,949.
TOTAL TO SCHEDULE D, PART XI, LINE 2D 618,540.
PART XI, LINE 4B - OTHER ADJUSTMENTS:
SPECIAL EVENT DIRECT BENEFIT COSTS 363,070.
PART XII, LINE 2D - OTHER ADJUSTMENTS:
SPECIAL EVENT EXPENSE 337,419.
PART XII, LINE 4B - OTHER ADJUSTMENTS:
INVESTMENT MANAGEMENT FEE 81,949.
SCHEDULE D, PART VI, LINE IE:
INCLUDED IN OTHER LAND, BUILDINGS AND EQUIPMENT IS $22,873,654 OF
CONSTRUCTION IN PROGRESS RELATED TO THE EXPANSION OF THE HOUSE'S Schedule D (Form 990) 2015
532055 09-21-15
ScheduleD(Form990)2015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 PaaeS {FartjXiK\ Supplemental Information (mntinimd)
F A C I L I T I E S .
Schedule D (Form 990) 2015 532055 09-21-15
SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information Regarding Fundraising or Gaming Activities Complete if the organization answered "Yes" on Form 990, Part IV, lines 17,18, or 19, or if the
organization entered more than $15,000 on Form 990-EZ, line 6a. • Attach to Form 990 or Form 990-EZ.
• Information about Schedule G (Form 990 or 990-EZ> and its instructions is at www im nnv/fgrrnQQC)
OMB No. 1545-0047
2015 Open to Public Inspection .
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615 i g g U p a Fundra is ing Act iv i t ies. Complete if the organization answered "Yes" on Form 990, Part IV, line 17. Form 990-EZ filers are not i:--'TVn.ri;»«"'l required to complete this part.
1 Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a I I Mail solicitations e I I Solicitation of non-government grants
f I I Solicitation of government grants
g I 1 Special fundraising events
b I I Internet and email solicitations
c I I Phone solicitations
d I I In-person solicitations
2 a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or
key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? I I Yes
b If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
• No
(i) Name and address of individual or entity (fundraiser)
(ii) Activity ( i i i ) Did
fundraiser have custody or control of
contributions?
Yes No
Total •
(iv) Gross receipts from activity
(v) Amount paid to (or retained by)
fundraiser listed in col. (i)
(vi) Amount paid to (or retained by)
organization
3 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2015
532081 09-14-15
ScheduleG(Form990or990Ea2015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Paa92 Part H | Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000
of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
3
1 CC
& § b
1 Gross receipts
2 Less: Contributions
3 Gross income (line 1 minus line 2)
4 Cash prizes
5 Noncash prizes
6 Rent/facility costs
7 Food and beverages
8 Entertainment
9 Other direct expenses
10 Direct expense summary. Add lines 4 through
11 Net income summary. Subtract line 10 from li
(a) Event #1
HOUSE PARTY! DINNER GALA
(event type)
765 ,865 .
298 ,500 .
467 ,365 .
6 7 , 9 1 7 .
7 1 , 4 6 4 .
30 ,500 . 317 ,505 .
9 in column (d)
ie 3, column (d)
(b) Event #2
RANDY CROSS INVITATIONAL
(event type)
301 ,190 .
126 .280 .
174 .910 .
24 ,900 .
25 ,400 .
79 ,170 .
(c) Other events
1 (total number)
173 ,705 .
173 ,705 .
•
(d) Total events
(add col. (a) through
col. (c))
1 ,240 ,760 .
598 ,485 .
642 ,275 .
92 ,817 .
9 6 , 8 6 4 .
30 ,500 . 396 ,675 . 616 ,856 .
2 5 , 4 1 9 . ^^^^m —g—J —LAV r i L i v v i j _ i ^ _ _ y m i •• i it*i y •_?»fvj*"f *•' ^twt in i ^ I v/ n \si i > m i ^ Wi W V i H l i l l i \\*f
[ Part ill | Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
0)
s >
CC
w 0) CO
s LU
i a
1 Grossrevenue
2 Cash prizes
3 Noncash prizes
4 Rent/facility costs
5 Other direct expenses
6 Volunteer labor
7 Direct expense summary. Add lines 2 through
8 Net aamina income summary. Subtract line 7
(a) Bingo
I I Yes %
• No
(b) Pull tabs/instant bingo/progressive bingo
I I Yes %
• No
(c) Other gaming
162 ,850 .
50 ,000 .
3 ,700 .
29 ,933 . 1 1 Yes %
[ S N O
5 in column (d) •
from line 1. column (d) •
(d) Total gaming (add col. (a) through col. (c))
162 .850 .
50 ,000 .
3 ,700 .
2 9 , 9 3 3 .
;lllil||llll 8 3 , 6 3 3 .
79 ,217 .
9 Enter the state(s) in which the organization conducts gaming activities: CA a Is the organization licensed to conduct gaming activities in each of these states? b If "No," explain:
m Yes • No
10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? I I Yes I X I No b If "Yes," explain:
532082 09-14-15 Schedule G (Form 990 or 990-EZ) 2015
ScheduleG(Form990or990-Ea2015 RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 PaoeS 11 Does the organization conduct gaming activities with nonmembers? I X I Yes I I No 12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed
to administer charitable gaming? I I Yes I X I No 13 Indicate the percentage of gaming activity conducted in:
1 0 0 . 0 0 % 13a 13b %
a The organization's facility b An outside facility
14 Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name • RONALD MCDONALD HOUSE AT STANFORD
Address • 520 SAND HILL ROAD - PALO ALTO, CA 94304
15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? I I Yes UXJ No
b If "Yes," enter the amount of gaming revenue received by the organization • $ and the amount of gaming revenue retained by the third party • $ .
c If "Yes," enter name and address of the third party:
Name •
Address •
16 Gaming manager information:
Name • N /A
Gaming manager compensation • $
Description of sen/ices provided •
I I Director/officer I I Employee | I Independent contractor
17 Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? L X J Yes I I No b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the
organization's own exempt activities during the tax year • $ 7 9 , 2 1 7 » Part IV| Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b,
15c, 16, and 17b, as applicable. Also provide any additional information (see instructions).
532083 09-14-15 Schedule G (Form 990 or 990-EZ) 2015
ScheduleG(Form990or990-Ea RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 Paae4 | Part IV | Supplemental Information (continued)
Schedule G (Form 990 or 990-EZ) 532084 04-01-15
SCHEDULE J (Form 990)
Department of the Treasury Internal Revenue Service
Compensation Information For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees • Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
• Attach to Form 990. • Information about Schedule J (Form 990) and its instructions is at www.irx.anvffnrmQQn
OMB No. 1545-0047
2015 Qpen to Public
Inspection Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615 Parti | Questions Regarding Compensation
1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990,
Part VII, Section A, line l a . Complete Part III to provide any relevant information regarding these items.
I I First-class or charter travel I I Housing allowance or residence for personal use
I I Travel for companions I I Payments for business use of personal residence
I I Tax indemnification and gross-up payments I I Health or social club dues or initiation fees
I I Discretionary spending account I I Personal services (e.g., maid, chauffeur, chef)
b If any of the boxes on line 1 a are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If" No," complete Part 111 to explain
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees, and officers, including the CEO/Executive Director, regarding the items checked in line 1a?
3 Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part III.
I X I Compensation committee I I Written employment contract
I X I Independent compensation consultant I X I Compensation survey or study
I I Form 990 of other organizations I X I Approval by the board or compensation committee
4 During the year, did any person listed on Form 990, Part VII, Section A, line 1 a, with respect to the filing
organization or a related organization:
a Receive a severance payment or change-of-control payment?
b Participate in, or receive payment from, a supplemental nonqualified retirement plan?
c Participate in, or receive payment from, an equity-based compensation arrangement?
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5 For persons listed on Form 990, Part VII, Section A, line l a , did the organization pay or accrue any compensation
contingent on the revenues of:
a The organization?
b Any related organization?
If "Yes" to line 5a or 5b, describe in Part III.
6 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the net earnings of:
a The organization?
b Any related organization?
If "Yes" on line 6a or 6b, describe in Part III.
7 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments
not described on lines 5 and 6? If "Yes," describe in Part III
8 Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III
9 If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958-6(cW
1b
4a
4b
4c
5a
5b
6a
6b
Yes
X
No
X
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2015
532111 10-14-15
Schedule J (Form 990) 2015 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 I Part II 1 Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed-
Page 2
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note: The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line la , applicable column (D) and (E) amounts for that individual.
(A) Name and Title
( 1 ) ANNETTE EROS
CHIEF EXECUTIVE OFFICER
( 2 ) LAURA BOUDREAU
COO
(i)
(ii)
0) (ii) (i)
(ii) (i)
(ii)
(i)
(ii) (i)
(ii) (i)
(ii) (i)
(ii) (i)
(ii) (i)
(ii) (0 (ii)
(i)
(ii) (i)
(ii) (i)
(ii) (i)
(ii)
(i)
M
(B) Breakdown of W-2 and/or 1099-MISC compensation
(i) Base compensation
173 ,235 . 0 .
134 ,807 . 0 .
(11) Bonus & incentive
compensation
0. 0. 0 . 0 .
(iii) Other reportable
compensation
0. 0 . 0 . 0 .
(C) Retirement and other deferred compensation
9 , 5 2 7 . 0 .
6 , 7 5 0 . 0 .
(D) Nontaxable benefits
1 7 , 6 1 4 . 0 .
8 , 6 1 7 . 0 .
(E) Total of columns (B)(i)-(D)
200 ,376 . 0 .
150 ,174 . 0 .
(F) Compensation in column (B)
reported as deferred on prior Form 990
0. 0 . 0 . 0 .
532112 10-14-15
Schedule J (Form 990) 2015
Schedule J (Form 990) 2015 RONALD MCDONALD HOUSE AT STANFORD 94-2538615 Page 3 Part IU Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1 a, 1 b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Schedule J (Form 990) 2015
532113 10-14-15
SCHEDULE M (Form 990)
Department of the Treasury Internal Revenue Service
Noncash Contributions
• Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
• Attach to Form 990.
• Information about Schedule M (Form 990) and its instructions is at wwwinsanv/fnrmQQn
OMB No. 1545-0047
2015 QpeaToPubBo
Inspection Name of the organization
| Part i,) Types of Property RONALD MCDONALD HOUSE AT STANFORD
Employer identification number
94-2538615
1 Art - Works of art
2 Art • Historical treasures
3 Art - Fractional interests
4 Books and publications
5 Clothing and household goods
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
12 Securities - Miscellaneous
13 Qualified conservation contribution -
Historic structures
14 Qualified 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 Taxidermy
22 Historical artifacts
23 Scientific specimens
24 Archeological artifacts
25 Other • ( F U R N I T U R E AND ) 26 Other • ( TOYS/HOUSE GO ) 27 Other • ( A U C T I O N I T E M S ) 28 Other • ( )
(a) Check if
applicable
X
X X X
(b) Number of
contributions or items contributed
1 4 , 6 8 3
66 614
16
29 Number of Forms 8283 received by the organization during the tax year for cc
for which the organization completed Form 8283, Part IV, Donee Acknowledg
(c) Noncash contribution amounts reported on
Form 990. Part VIII. line 1a
5 1 4 , 1 4 9 .
5 2 7 , 4 3 8 . 1 9 2 , 6 1 7 .
1 3 , 8 5 3 .
jntributions
ement 29
(d) Method of determining
noncash contribution amounts
FAIR MARKET VALUE
COST OF COMPARABLE G COST OF COMPARABLE G COST OF COMPARABLE G
0
30a During the year, did the organization receive by contribution any property reported in Part 1, lines 1 through 28, that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used for
exempt purposes for the entire holding period?
b If "Yes," describe the arrangement in Part II.
31 Does the organization have a gift acceptance policy that requires the review of any non-standard contribu
32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions?
ions?
b If "Yes," describe in Part II.
33 If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
30a
31
32a
Yes
X
X
No
X
• I
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2015)
532141 08-21-15
ScheduleM(Form990X201 a RONALD MCDONALD HOUSE AT STANFORD 9 4 - 2 5 3 8 6 1 5 PaQe2 IPftrt fll Supplemental information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization
is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
SCHEDULE M, PART I, COLUMN (B) :
SCHEDULE M, LINE 26, OTHER; DONATED GOODS RECEIVED FROM VARIOUS DONORS
INCLUDING TOYS AND HOUSEHOLD ITEMS UTILIZED BY THE HOUSE TO FULFILL ITS
MISSION BY DEFRAYING COSTS THAT WOULD OTHERWISE BE INCURRED FOR PROGRAM
SERVICES.
SCHEDULE M, LINE 25 OTHER: DONATED FURNITURE AND DECOR RECEIVED FROM
VARIOUS DONORS AS PART OF THE HOUSE'S EXPANSION INTO IT'S NEW BUILDING.
SCHEDULE M, LINE 32B:
A BROKER IS USED TO RECEIVE CONTRIBUTIONS OF STOCK, UPON RECEIPT THE
STOCK IS LIQUIDATED.
532142 08-21-15 Schedule M (Form 990) (2015)
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to 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.
^ Information about Schedule O (Form 990 or 990-EZ] and its instructions is at www iKpnv/fprmQQn.
0MB No. 1545-0047
2015 Open to Public Inspection 'tm
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
FORM 990, PART III, LINE 4
WITH THE ADDITION OF NINE NEW GUEST ROOMS TO THE CURRENT HOUSE, THE
FULL CAMPUS INCREASES THE NUMBER OF GUEST ROOMS FROM 47 TO 123 ALLOWING
THE HOUSE TO SERVE EVEN MORE CHILDREN WITH LIFE-THREATENING ILLNESSES,
AND THEIR FAMILIES.
FAMILIES OF CRITICALLY ILL CHILDREN AGE 21 AND UNDER ARE REFERRED TO
THE HOUSE BY HOSPITAL SOCIAL WORKERS. THE HOUSE REQUESTS ONLY A NOMINAL
$10 PER NIGHT, PER FAMILY, WHICH DEFRAYS ONLY A SMALL PART OF THE
ACTUAL HOUSING COST. NO FAMILY IS EVER TURNED AWAY DUE TO INABILITY TO
PAY. THE HOUSE IS AN APPROVED LODGING FACILITY FOR FAMILIES COVERED BY
CALIFORNIA CHILDREN'S SERVICES AND MANY OTHER STATE-FUNDED AND PRIVATE
INSURANCE PLANS.
THE AVERAGE LENGTH OF STAY AT THE HOUSE HAS RISEN DRAMATICALLY AS
MEDICAL ADVANCES ALLOW DOCTORS TO TREAT CHILDREN FACING CRITICAL
ILLNESSES THAT ONLY DECADES AGO WERE FATAL. IN 2015, THE HOUSE PROVIDED
ACCOMMODATION TO MORE THAN 600 FAMILIES, TOTALING MORE THAN 16,000
GUEST NIGHTS. WHILE THE AVERAGE LENGTH OF STAY FOR A FAMILY IN 2015 WAS
34 DAYS, MORE THAN 60 PERCENT OF HOUSE ROOMS WERE NEEDED FOR LONG-TERM
STAYS OF 38 DAYS OR MORE.
IN ORDER TO ASSIST FAMILIES WHO ARE STAYING AT THE HOUSE FOR LONG-TERM
STAYS, HOUSE VOLUNTEERS STAFF TEEN AND CHILDREN'S ACTIVITY ROOMS, A
COMPUTER LAB, SUMMER CAMP, AND OTHER ACTIVITIES. FAMILIES STAYING
LONG-TERM REQUIRE MORE ACTIVITIES, ESPECIALLY FOR YOUNG CHILDREN WHO LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2015) 532211 09-02-15
Schedule O (Form 990 or 990-Ea (2015^ Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
ARE FAR FROM HOME FOR LONG PERIODS OF TIME. ACTIVITIES THAT BUILD A
STRONG COMMUNITY AT THE HOUSE PROVIDE THERAPEUTIC BENEFITS TO CHILDREN
AND FAMILIES AND AID IN THE HEALING PROCESS. KEEPING A REGULAR ROUTINE
HELPS FAMILIES MAINTAIN A SENSE OF NORMALCY WHILE LIVING AWAY FROM
HOME.
A HOME-AWAY-FROM-HOME
SERVICES AT THE HOUSE NURTURE THE ENTIRE FAMILY IN ADDITION TO THE
CRITICALLY ILL CHILD. HEALING AND PERSONAL WELL-BEING FORM THE
FRAMEWORK FOR COMPREHENSIVE PROGRAMMING AT THE HOUSE. OUR MISSION IS TO
CREATE AN ENVIRONMENT WHERE ADULTS AND CHILDREN FEEL NURTURED AND SAFE,
AND WHERE OFFERED PROGRAMS ENRICH THEIR LIVES WHILE AMELIORATING THE
STRESS OF COMPLEX CRITICAL TREATMENTS LIKE OPEN-HEART SURGERY, KIDNEY,
LUNG OR LIVER TRANSPLANTS, RADIATION, OR BONE MARROW TRANSPLANTS. WHAT
A FAMILY RECEIVES WHEN THEY STAY AT THE HOUSE IS MUCH MORE THAN
SHELTER. THEY ALSO RECEIVE THE EMPATHY AND SUPPORT OF ALL THE OTHER
FAMILIES WITH CRITICALLY ILL CHILDREN RESIDING AT THE HOUSE.
STAFF IS RESPONSIBLE FOR ENSURING THAT THE GUEST ROOMS ARE FULLY
UTILIZED. MORE THAN 150 VOLUNTEERS SUPPORT THE GUESTS AND STAFF AT THE
HOUSE BY PROVIDING OFFICE ASSISTANCE, ACTIVITY COORDINATION, MEAL
PREPARATION FOR FAMILIES, BUILDING MAINTENANCE, AND SUPERVISION OF
CHILDREN'S PLAY AREAS AND THE COMPUTER/GAMING ROOM. ADDITIONALLY, THE
FAMILY SUPPORT SERVICES PROGRAM PROVIDES SUPPORT TO FAMILIES IN A
THERAPEUTIC ENVIRONMENT THROUGH ACTIVITIES, WELCOME MEETINGS AND
TRAININGS.
SERVICES PROVIDED FOR FAMILIES ARE WHAT TRULY MAKE THIS HOUSE A "HOME 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-Ea (2015) Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
AWAY FROM HOME," AND ENABLE FAMILY MEMBERS TO FOCUS ON THEIR NUMBER ONE
PRIORITY; CARING FOR AN ILL CHILD, FAMILY ACTIVITIES PROVIDE AN
ENVIRONMENT WHERE ORGANIC AND INFORMAL SUPPORT GROUPS ARE FORMED,
STRESS LEVELS ARE DECREASED, AND SMALL "ESCAPES" CAN BE ENJOYED. MORE
THAN 3,000 VOLUNTEERS SUPPORT THE FOLLOWING PROGRAMS THAT BRING COMFORT
AND CARE TO FAMILIES DURING A VERY DIFFICULT TIME:
D MEALS FOR MUNCHKINS
D FAMILY ALBUM PROJECT PHOTO SESSIONS
D HOLIDAY EVENTS AND ACTIVITIES
D HEALTH AND WELLNESS PROGRAMS (MASSAGE THERAPY, HAIRCUTS, SPA
TREATMENTS)
D WEEKLY SHOPPING TRIPS TO AREA STORES
ADDITIONALLY, 23 VOLUNTEERS PROVIDE VITAL SUPPORT FOR THE HOUSE BY
SERVING AS MEMBERS OF ITS BOARD OF DIRECTORS, AND ANNUALLY, MORE THAN
75 VOLUNTEERS HELP MANAGE AND COORDINATE THE HOUSE'S TWO ANNUAL MAJOR
FUNDRAISING EVENTS. IN 2015, VOLUNTEERS DONATED MORE THAN 20,000 HOURS
OF TIME FOR AN ESTIMATED VALUE OF OVER $550,000, DRAMATICALLY REDUCING
THE NEED FOR HIRED STAFF.
OTHER PROGRAMS
ADDITIONALLY, THE HOUSE HAS TWO PROGRAMS TO SERVE EVEN MORE FAMILIES OF
CRITICALLY ILL CHILDREN WHO ARE NOT CURRENTLY STAYING AT THE HOUSE.
HAPPY WHEELS IS A MOBILE HOSPITALITY CART THAT MAKES ROUNDS AT LUCILE
PACKARD CHILDREN'S HOSPITAL STANFORD. STAFFED BY HOUSE VOLUNTEERS,
HAPPY WHEELS PROVIDES A BIT OF COMFORT AND CARE TO PARENTS BY OFFERING 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-EZ) (2015) Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
TOILETRIES, A HOT BEVERAGE OR SNACK, OR ENTERTAINING BOOKS, ACTIVITIES,
AND TOYS FOR CHILDREN. THE DAY PASS PROGRAM INVITES FAMILIES WHOSE
CHILDREN ARE BEING TREATED AT LUCILE PACKARD CHILDREN'S HOSPITAL
STANFORD TO ENJOY THE COMFORT AND AMENITIES OFFERED AT THE HOUSE DAILY
FROM 9 A.M. TO 9 P.M. DAY PASS PROVIDES AN OPPORTUNITY FOR FAMILIES
STAYING IN HOTELS OR BEDSIDE TO GET THE RESPITE THEY NEED TO HELP THEM
MAINTAIN THEIR FOCUS ON THEIR CHILD'S HEALTH. IN 2015, THE HOUSE SERVED
MORE THAN 10,800 INDIVIDUALS THROUGH THE DAY PASS AND HAPPY WHEELS
PROGRAMS.
A WELL-MAINTAINED FACILITY TO REVIEW
THE HOUSE OFFERS A TRUSTED ENVIRONMENT FOR CRITICALLY ILL CHILDREN TO
STAY, WITH THE NEW FACILITY SPECIFICALLY DESIGNED TO SUPPORT CHILDREN
WITH SUPPRESSED IMMUNE SYSTEMS DUE TO HEART, LUNG, OR STEM CELL
TRANSPLANTS. LUCILE PACKARD CHILDREN'S HOSPITAL STANFORD DOCTORS ARE
MORE LIKELY TO DISCHARGE A PATIENT SOONER IF THEY KNOW THE CHILD WILL
BE STAYING AT THE HOUSE. IN ORDER TO ENSURE A WELL-MAINTAINED FACILITY,
THE HOUSE UPHOLDS A PREVENTATIVE MAINTENANCE PROGRAM TO KEEP ALL
SYSTEMS IN OPTIMAL OPERATING CONDITION. THE HOUSE HAS ALSO EMBARKED ON
A GREEN INITIATIVE, REPLACING ALL ITS CLEANING PRODUCTS WITH GREEN
ALTERNATIVES, AND IS CURRENTLY EVALUATING ALL AREAS TO DISCOVER WHERE
ADDITIONAL ENVIRONMENTALLY SUSTAINING ALTERNATIVES ARE APPROPRIATE.
LEVERAGING RESOURCES
APPROXIMATELY $280,000 OF IN-KIND DONATIONS OF GOODS AND SERVICES WERE
RECEIVED IN 2015, COVERING PROGRAM EXPENSES THAT THE CHARITY WOULD
OTHERWISE HAVE TO PAY, AS WELL AS SPECIAL GIFTS FOR FAMILIES AND 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-Ea (2015) Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
CHILDREN, MAJOR IN-KIND DONATIONS INCLUDE LINEN SERVICE, SOFT DRINKS,
EVENT TICKETS, DONATED DINNERS, CLEANING SUPPLIES, DAILY NEWSPAPERS,
AND TOYS AND GAMES FOR CHILDREN AND FAMILIES. ALSO IN 2015, THE HOUSE
PARTNERED WITH THE SAN FRANCISCO DESIGN CENTER AND 48 OF THE AREA'S TOP
INTERIOR DESIGNERS TO CREATE A WELCOMING AND INVITING HOME-AWAY-FROM
HOME IN THE NEW FACILITY. THIS WELCOMING ENVIRONMENT SURROUNDS THE
FAMILIES WITH COMFORT AND RELIEF THE MOMENT THEY WALK IN THE DOOR. THE
SAN FRANCISCO DESIGN CENTER AND DESIGNERS GENEROUSLY DONATED ALL
MATERIALS AND LABOR ON THIS PROJECT WITH THE HOUSE RECEIVING OVER
$530,000 OF DONATED DECOR AND FURNITURE. IN ADDITION, THE HOUSE IS
SITUATED ON PROPERTY LEASED FOR $1.00 A YEAR FROM STANFORD UNIVERSITY.
THE ANNUAL DONATED LEASE AMOUNT IS CURRENTLY VALUED AT $1,934,008.
RELYING ON COMMUNITY SUPPORT
THE HOUSE RECEIVES MORE THAN 85 PERCENT OF ITS REVENUE FROM
CONTRIBUTIONS, AND RELIES HEAVILY ON VOLUNTEERS TO PROVIDE HUNDREDS OF
STAFFING HOURS EACH WEEK. THEREFORE, COMMUNITY SUPPORT IS CRUCIAL TO
THE SUCCESS OF THE HOUSE. ROOM REVENUE REPRESENTS LESS THAN 5 PERCENT
OF THE TOTAL COST OF HOUSING FAMILIES WHO STAY AT THE HOUSE. THIS ROOM
REVENUE INCLUDES THE ROOM RATE PAID BY FAMILIES, BASED ON THEIR ABILITY
TO PAY, AS WELL AS ROOM REVENUE PAID BY STATE-FUNDED AGENCIES, BASED ON
THE ELIGIBILITY OF FAMILIES TO RECEIVE THIS AID. NO FAMILY IS EVER
DENIED ACCOMMODATION DUE TO AN INABILITY TO PAY.
AS ROOM REVENUE IS THE ONLY TYPE OF EARNED REVENUE RECEIVED, THE
REMAINING 95-PLUS PERCENT OF THE COST OF PROVIDING HOUSING IS FUNDED BY
CONTRIBUTIONS. OF THE 95-PLUS PERCENT RAISED TO SUPPORT THE MISSION OF 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-Ea (20151 Paae 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
THE HOUSE, APPROXIMATELY EIGHT PERCENT IS GENERATED FROM MCDONALD'S
CORPORATION, ITS FRANCHISE OWNER/OPERATORS, AND THEIR LOCAL CHARITY
CHAPTER. THE REMAINING 87 PERCENT OF DONATIONS COME FROM INDIVIDUALS,
FOUNDATIONS, AND CORPORATIONS. THANKS TO THE OVERWHELMING FINANCIAL
SUPPORT AND GENEROSITY OF OUR COMMUNITY, WE ARE ABLE TO OFFER COMFORT
AND CARE TO FAMILIES OF CRITICALLY ILL CHILDREN.
HOPE HAS GROWN
IN MAY 2016 THE HOUSE OPENED ITS NEW 52,000 SQUARE FOOT FACILITY ( THE
ARRILLAGA FAMILY CENTER) DIRECTLY ADJACENT TO THE EXISTING HOUSE (THE
TAUBE FAMILY CENTER). THIS NEW FACILITY INCLUDES 67 ADDITIONAL PRIVATE
GUEST ROOMS, HOME-LIKE KITCHEN AND DINING AREAS, COMFORTABLE LIVING
SPACES, A FITNESS AND REHABILITATION FACILITY, AGE-SPECIFIC ACTIVITY
ROOMS, A CLASSROOM AND A HEALING GARDEN AND RETREAT.
IN JUNE 2016 AN ADDITIONAL EXPANSION BEGAN ON THE EXISTING HOUSE TO ADD
NINE NEW GUEST ROOMS AND ALLOW THE TWO BUILDINGS TO FUNCTION AS ONE
COHESIVE CAMPUS. THIS PHASE 2 EXPANSION IS ANTICIPATED TO BE COMPLETED
BY SPRING 2017 AND WILL ALLOW THE HOUSE TO SERVE 123 FAMILIES EACH
NIGHT.
THIS INCREASED CAPACITY WILL ADDRESS THE CURRENT DEMAND AS WELL AS THE
FUTURE NEEDS ANTICIPATED BY THE EXPANSION OF LUCILE PACKARD CHILDREN'S
HOSPITAL STANFORD. LOCATED ONLY A FEW BLOCKS FROM LUCILE PACKARD
CHILDREN'S HOSPITAL STANFORD, THE PROXIMITY OF THE HOUSE TO THE
HOSPITAL HELPS FAMILIES FACING A MEDICAL CRISIS STAY TOGETHER AS
PARENTS AND MEDICAL STAFF ARE REASSURED THAT IN THE EVENT OF A MEDICAL 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule 0 (Form 990 or 990-EZ) (2015) Paae2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
EMERGENCY, THE HOSPITAL IS A MINUTE AWAY. THIS PROXIMITY HAS OTHER REAL
ADVANTAGES AS WELL. RECENT STUDIES INDICATE THAT THE PRESENCE OF A
PARENT CAN CUT THE AVERAGE LENGTH OF CHILD'S HOSPITAL STAY BY 31
PERCENT.
RONALD MCDONALD HOUSE AT STANFORD IS WHERE HOPE HAS A HOME.
FORM 990 PART I LINE 15:
AS PART OF ITS EXPANSION AND PROJECTED INCREASED CAPACITY TO 123 ROOMS,
THE HOUSE BEGAN OVERNIGHT AWAKE STAFFING SEVEN DAYS A WEEK IN 2015.
WITH MORE FAMILIES IN THE HOUSE IT IS CRITICAL TO HAVE STAFF AWAKE AND
AVAILABLE TO SUPPORT FAMILIES AT ANY HOUR OF THE DAY. ALSO, AS PART
OF THE EXPANSION, THE FAMILY SUPPORT SERVICES PROGRAM WAS LAUNCHED TO
PROVIDE SUPPORT TO FAMILIES IN A THERAPEUTIC ENVIRONMENT THROUGH
ACTIVITIES, WELCOME MEETINGS AND TRAININGS. ALONG WITH ADDITIONAL
ADMINISTRATIVE SUPPORT THE RESULTING INCREASE IN SALARIES AND BENEFITS
FROM THESE STAFFING ADDITIONS IN 2015 WAS APPROXIMATELY $360,000 FOR 8
FULL TIME EQUIVALENT POSITIONS.
FORM 990, PART VI, SECTION B, LINE 11:
THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO REVIEW THE
ORGANIZATION'S FORM 990 BEFORE IT IS FILED WITH THE IRS. THE FINANCE
COMMITTEE SUBSEQUENTLY REVIEWS THE FORM 990 AND APPROVES IT FOR SUBMISSION
TO THE IRS. COPIES OF THE FORM 990 AND ALL RELATED SCHEDULES ARE PROVIDED
TO THE BOARD OF DIRECTORS BEFORE IT IS FILED.
532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-EZ) (2015) Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
FORM 990, PART VI, SECTION B, LINE 12Ct
DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE ANNUALLY REQUIRED TO COMPLETE A
CONFLICT OF INTEREST DISCLOSURE STATEMENT AS A PRECURSOR TO THEIR SERVICE
TO THE HOUSE. TO PROTECT THE INTEGRITY OF THE DECISION-MAKING PROCESS OF
THE HOUSE, POTENTIAL AND ACTUAL AS WELL AS PERCEIVED CONFLICTS BETWEEN THE
HOUSE AND THE INDIVIDUAL'S PERSONAL, PROFESSIONAL AND BUSINESS INTERESTS
ARE TO BE DISCLOSED. POTENTIAL CONFLICTS ARE LOGGED WITH AND MONITORED BY
THE SECRETARY OF THE BOARD AND REVIEWED BY A COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15A:
THE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS AND OFFICERS
OF THE HOUSE'S GOVERNING BODY, MEETS ANNUALLY TO REVIEW AND APPROVE THE
COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. USING INPUT FROM AN OUTSIDE
COMPENSATION FIRM, THE COMMITTEE REVIEWS ANALYSIS OF SIMILARLY QUALIFIED
PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS
PREPARED BY AN INDEPENDENT COMPENSATION CONSULTANT. MINUTES OF THE MEETING
ARE RECORDED AND FILED. THIS PROCESS WAS LAST UNDERTAKEN FOR FISCAL 2015.
FORM 990, PART VI, SECTION C, LINE 19;
THE HOUSE MAINTAINS ITS ARTICLES OF INCORPORATION, BY-LAWS, CONFLICT OF
INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS AT ITS CURRENT LOCATION;
520 SAND HILL ROAD IN PALO ALTO, CALIFORNIA. COPIES OF THESE DOCUMENTS ARE
AVAILABLE ON REQUEST FOR A NOMINAL FEE. THE MOST RECENT FORM 990 AND
AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE HOUSE'S WEBSITE.
FORM 990, PART X, LINE 15;
THE HOUSE AND ITS FACILITIES ARE LOCATED ON A LEASED PARCEL OF LAND IN
PALO ALTO, CALIFORNIA. THE TERMS OF THE LEASE REQUIRE AN ANNUAL RENTAL 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-EZ) (2015) Page 2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
PAYMENT OF $1 THROUGH THE YEAR 2048. IN 2014, THE HOUSE RECOGNIZED AS
REVENUE AND A CONTRIBUTION RECEIVABLE THE DIFFERENCE BETWEEN THE FAIR
RENTAL VALUE OF THE PROPERTY AND THE PRESENT VALUE OF THE STATED AMOUNT
OF THE LEASE PAYMENTS AT THE DATE OF CONTRIBUTION. THE CONTRIBUTION
RECEIVABLE AS OF DECEMBER 31, 2015 IS AS FOLLOWS;
NONCURRENT PORTION OF CONTRIBUTION RECEIVABLE: $61,007,986
LESS; DISCOUNT TO NET PRESENT VALUE: (40,575,144)
NONCURRENT PORTION OF CONTRIBUTION RECEIVABLE, NET: 20,432,842
CURRENT PORTION OF CONTRIBUTION RECEIVABLE: 1,934,000
NET BENEFICIAL USE OF LAND: $22,366,842
FORM 990, PART X, LINE 24
IN 2015 THE HOUSE ENTERED INTO A CREDIT AGREEMENT WITH THE DAVID AND
LUCILE PACKARD FOUNDATION ("CREDIT AGREEMENT"). THE CREDIT AGREEMENT
PROVIDES FOR A TERM LOAN OF UP TO $10,000,000 TO BE USED TO
BRIDGE-FINANCE PLEDGE COMMITMENTS SECURED BY THE HOUSE TO PAY COSTS FOR
CONSTRUCTING THE NEW 3-STORY, 52,000 SQUARE FOOT FACILITY. BORROWINGS
BEAR INTEREST AT ONE PERCENT (1%) PER YEAR. THE HOUSE USED A FAIR
MARKET INTEREST RATE OF 3.5% TO IMPUTE DISCOUNTED INTEREST AND
RECOGNIZE A $277,000 CONTRIBUTION AND RESULTING DEBT DISCOUNT. THE
DISCOUNT IS BEING AMORTIZED TO INTEREST EXPENSE OVER THE TERM OF THE
NOTE. DURING 2015, THE HOUSE WAS ADVANCED A TOTAL OF $8,410,000.
PRINCIPAL PAYMENTS ARE BASED ON THE PLEDGE COMMITMENTS SECURED BY THE 532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
Schedule O (Form 990 or 990-EZ) (2015) Paae2
Name of the organization
RONALD MCDONALD HOUSE AT STANFORD Employer identification number
94-2538615
HOUSE WITH PRINCIPAL AND INTEREST DUE ON NOVEMBER 1 AND MAY 1 OF EACH
YEAR. ALL UNPAID ACCRUED INTEREST AND PRINCIPAL ARE DUE ON OR BEFORE
THE FIVE YEAR ANNIVERSARY OF THE LAST PRINCIPAL ADVANCE,
LONG TERM DEBT CONSISTS OF THE FOLLOWING AT DECEMBER 31, 2015:
PRINCIPAL DUE $7,750,000
LESS: UNAMORTIZED DISCOUNT (277,000)
NET AMOUNT $7,473,000
FORM 990, PART XII, LINE 2C:
THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.
532212 09-02-15 Schedule O (Form 990 or 990-EZ) (2015)
2015 DEPRECIATION AND AMORTIZATION REPORT
FORM 9 9 0 PAGE 10 990
Asset No.
1
2
' 3
4
Description
BUILDINGS
BUILDING
* 9 9 0 PAGE 1 0 TOTAL
BUILDINGS
MACHINERY.& EQUIPMENT
FURNITURE AND EQUIPMENT
* 9 9 0 PAGE 1 0 TOTAL •
MACHINERY &' EQUIPMENT
OTHER
ARTWORK '
CONSTRUCTION I N PROCESS
* 9 9 0 PAGE 1 0 TOTAL OTHER
* GRAND TOTAL 9 9 0 PAGE 1 0
DEPR
- ' - i'' •• ' • . •
Date Acquired
VARIOUS
VARIOUS
' ..'
VARIOUS
VARIOUS
Method
SL .
SL
NC' .'
NC
Life
4 0 t 0 t
1 0 . 0 0
. 0 0 0
. 0 0 0
c 0 n V
m
m
Line No.
16
16
Unadjusted Cost Or Basis
1 7 1 8 4 7 6 2 .
1 7 1 8 4 7 6 2 .
3 2 6 , 5 8 1 .
3 2 £ , 5 8 1 .
4 6 , 9 5 3 .
2 2 8 7 3 6 5 4 .
2 2 9 2 0 6 0 7 .
4 0 4 3 1 9 5 0 .
Bus
% Exd
Section 179 Expense
,/
Reduction In Basis
Basis For Depreciation
1 7 1 8 4 7 6 2 , !
1 7 1 8 4 7 6 2 .
3 2 6 , 5 8 1 .
3 2 6 , 5 8 1 .
4 6 , 9 5 3 .
2 2 8 7 3 6 5 4 .
2 2 9 2 0 6 0 7 4
4 0 4 3 1 9 5 0 . !
Beginning Accumulated Depreciation
, 5 7 0 , 3 9 5 .
, 5 7 0 , 3 9 5 .
2 1 7 , 4 7 6 .
2 1 7 , 4 7 6 .
0 .
, 7 8 7 , 8 7 1 .
Current Sec 179 Expense
Current Year Deduction
. 4 1 3 , 6 8 3 .
4 1 3 , 6 8 3 .
2 7 , 8 2 6 .
2 7 , 8 2 6 .
0 .
0 .
0 ;
4 4 1 , 5 0 9 .
Ending Accumulated Depreciation
1 , 9 8 4 , 0 7 8 .
. , 9 8 4 , 0 7 8 .
2 4 5 , 3 0 2 .
2 4 5 , 3 0 2 ' .
. . 0 ;
1 , 2 2 9 , 3 8 0 .
528111 04-01-15 (D) - Asset disposed * ITC, Salvage, Bonus, Commercial Revitalization Deduction, GO Zone
Form 0 8 6 8
(Rev. January 2014)
Department of the Treasury Internal Revenue Service
Application for Extension of Time To File an Exempt Organization Return
• File a separate application for each return.
• Information about Form 8868 and its instructions is at www.irs.gov/form8868
OMB No. 1545-1709
• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box • I X I
• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing (e-file) • You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation
required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension
of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain
Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,
Visit wwwjn* nnvMile and dick on P-ffte fnr Charities X, Nnnnmfit*
I Part I 1 Automatic 3-Month Extension of Time. Only submit original (no copies needed) A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete
Part I only • E H
All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time to file income tax returns. Enter filer's identifying number
Type or
File by the due date for filing your return. See instructions.
Name of exempt organization or other filer, see instructions.
RONALD MCDONALD HOUSE AT STANFORD
Employer identification number (EIN) or
94-2538615 Number, street, and room or suite no. If a P.O. box, see instructions.
520 SAND HILL ROAD Social security number (SSN)
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
PALO ALTO, CA 94304
Enter the Return code for the return that this application is for (file a separate application for each return) I 0 I 1
Application
Is For
Form 990 or Form 990-EZ
Form 990-BL
Form 4720 fmdividual)
Form 990-PF
Form 990-T (sec. 401 (a) or 408(a) trust)
Form 990-T (trust other than above)
Return
Code
01
02
03
04
05
06
Application
Is For
Form 990-T (corporation)
Form 1041-A
Form 4720 (other than individual)
Form 5227
Form 6069
Form 8870
Return
Code
07
08
09
10
11
12
• The books are in the care of • CYNTHIA SEMENOFF, DIRECTOR OF FINANCE 520 SAND HILL ROAD - PALO ALTO, CA 94304
Telephone No. • 6 5 0 - 4 7 0 - 6 0 0 9 Fax No. •
• If the organization does not have an office or place of business in the United States, check this box • I I
• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check this
box ^ I I . If it is for part of the group, check this box • ! I and attach a list with the names and EINs of all members the extension is for.
1 I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until
AUGUST 15 , 2016 , to file the exempt organization return for the organization named above. The extension
is for the organization's return for:
• I X 1 calendar year 2 0 1 5 or
• I I tax year beginning , and ending
If the tax year entered in line 1 is for less than 12 months, check reason:
I I Change in accounting period
I I Initial return I I Final return
3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions. 3a
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit. 3b
Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
by using EFTPS (Electronic Federal Tax Payment System). See instructions. 3c
Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment instructions.
LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. 523841 04-01-15
Form 8868 (Rev. 1-2014)
