HAWAII DENTAL SERVICE FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HAWAII DENTAL SERVICE FOUNDATION (EIN 99-0246999)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-12
- IRS object ID
- 201722859349301802
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-12T20:50:16-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 205325889 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCUITY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 BISHOP STREET STE 1900 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990246999 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAWA | BusinessNameControlTxt |
| Phone | 8085211431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET NO 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK H YAMAKAWA | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 8085211431 | PhoneNum |
| Signature | 2017-09-28 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIM AT JONES | PreparerPersonNm |
| PTIN | P00940140 | PTIN |
| Phone | 8085313400 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 72.253.96.98 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-09-28 | IPDt |
| IP Tm | 08:57:21 | IPTm |
| IP Timezone | HS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 1B4AB77F77468A1A1345A306DF907DFB530EC2BE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C4CD8BAE590A433923FB580B5E8ADEF4B40016B9 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN KOTAKE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP ST STE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,622,141 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE THE WELFARE OF THE COMMUNITY AND CONTRIBUTE TO THE CHARITABLE AND HEALTH ISSUES OF THE COMMUNITY. (SEE SCHEDULE O) | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,344,658 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,513,932 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $798,186 | PYInvestmentIncomeAmt |
| CY Investment Income | $971,520 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,142,844 | PYTotalRevenueAmt |
| CY Total Revenue | $5,485,452 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $930,968 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $965,749 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,836 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,618 | PYOtherExpensesAmt |
| CY Other Expenses | $64,379 | CYOtherExpensesAmt |
| PY Total Expenses | $976,586 | PYTotalExpensesAmt |
| CY Total Expenses | $1,063,964 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,166,258 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,421,488 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,865,188 | TotalAssetsBOYAmt |
| Total Assets EOY | $36,540,340 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,350 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,156 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,857,838 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $36,530,184 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL HEALTH AND WELFARE OF THE PEOPLE OF THE COMMUNITY AND ADVANCE RESEARCH, EDUCATION, STUDY AND LEARNING IN THE HEALTH AREAS SUCH AS DENTISTRY, ORAL HYGIENE AND RELATED SERVICE. (SEE SCHEDULE O). | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $975,043 | ExpenseAmt |
| Grant | $965,749 | GrantAmt |
| Desc | DURING 2016, HDSF DISTRIBUTED $965,749 TO 10 ORGANIZATIONS WHO HAVEPROGRAMS IN PLACE TO SUPPORT ORAL HEALTH INITIATIVES IN HAWAII AND CALIFORNIA.SEE SCHEDULE I FOR ADDITIONAL DETAILS. | Desc |
| Total Program Service Expenses | $975,043 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERYL TAKITANI-SMITH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8085211431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| SUSAN LI | |||||||
| VICE CHAIR (TERMED 5/2016) | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN KOTAKE | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PAUL CHANG | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CASEY TAMASHIRO | |||||||
| PRESIDENT | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CHARLES SUGIYAMA | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MASON A SAVAGE | |||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SHAKIL AHMED | |||||||
| TRUSTEE | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CHERYL TAKITANI-SMITH | |||||||
| TREASURER | 1.00 | 41.00 | $0 | $251,420 | $92,841 | Yes (X) | |
| MARK H YAMAKAWA | |||||||
| VICE PRESIDENT | 1.00 | 41.00 | $0 | $505,572 | $68,850 | Yes (X) | |
| KATHY FAY | |||||||
| SECRETARY | 1.00 | 41.00 | $0 | $251,261 | $38,464 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,008,253 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $200,155 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $4,513,932 | RelatedOrganizationsAmt |
| Total Contributions | $4,513,932 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $659,270 | TotalRevenueColumnAmt |
| Exclusion | $659,270 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,448,939 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,136,689 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $312,250 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $312,250 | TotalRevenueColumnAmt |
| Exclusion | $312,250 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,485,452 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $971,520 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $965,749 | TotalAmt |
| Program Services | $965,749 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,836 | TotalAmt |
| Management And General | $33,836 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,172 | TotalAmt |
| Management And General | $7,172 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,094 | TotalAmt |
| Management And General | $39,094 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Management And General | $2,500 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35 | TotalAmt |
| Management And General | $35 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,982 | TotalAmt |
| Management And General | $5,982 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287 | TotalAmt |
| Management And General | $287 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| ORAL HEALTH OUTREACH | $9,294 | $9,294 | |
| MISCELLANEOUS | $15 | $15 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,063,964 | TotalAmt |
| Program Services | $975,043 | ProgramServicesAmt |
| Management And General | $88,921 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $585,822 | BOYAmt |
| EOY | $851,618 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,344,658 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,117 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,912,099 | BOYAmt |
| EOY | $35,669,230 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,492 | BOYAmt |
| EOY | $19,492 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,865,188 | BOYAmt |
| EOY | $36,540,340 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,350 | BOYAmt |
| EOY | $10,156 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,350 | BOYAmt |
| EOY | $10,156 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,857,838 | BOYAmt |
| EOY | $36,530,184 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,857,838 | BOYAmt |
| EOY | $36,530,184 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,865,188 | BOYAmt |
| EOY | $36,540,340 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,421,488 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,250,857 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| UNIVERSITY OF HAWAII FOUNDATION | |||||||
| PO BOX 11270 | HONOLULU | HI | 968280270 | 990085260 | 501(C)(3) | $60,000 | PROVIDE ORAL HEALTH EDUCATION. |
| ALOHA MEDICAL MISSION | |||||||
| 810 N VINEYARD BLVD | HONOLULU | HI | 96817 | 990234811 | 501(C)(3) | $150,000 | DENTAL CLINIC SERVING UNINSURED AND UNDERSERVED. |
| HUI NO KE OLA PONO | |||||||
| 95 MAHALANI STREET | WAILUKU | HI | 96793 | 990287193 | 501(C)(3) | $125,205 | DENTAL CARE TO UNINSURED AND UNDERSERVED. |
| LANAI COMMUNITY HEALTH CENTER | |||||||
| PO BOX 630142 | LANAI CITY | HI | 96763 | 202509287 | 501(C)(3) | $136,141 | PURCHASE OF DENTAL EQUIPMENT. |
| UNIVERSITY OF THE PACIFIC | |||||||
| 3601 PACIFIC AVENUE | STOCKTON | CA | 95211 | 941156266 | 501(C)(3) | $158,867 | FUND VIRTUAL DENTAL HOME PROJECT. |
| KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES | |||||||
| 2239 NORTH SCHOOL STREET | HONOLULU | HI | 96819 | 990149797 | 501(C)(3) | $200,000 | DENTAL CARE TO UNINSURED AND UNDERSERVED |
| BAY CLINIC | |||||||
| 450 KILAUEA AVENUE SUITE 105 | HONOLULU | HI | 96720 | 990222784 | 501(C)(3) | $48,596 | PURCHASE OF DENTAL EQUIPMENT |
| DENTAL LIFELINE NETWORK | |||||||
| 1800 15TH STREET SUITE 100 | DENVER | CO | 80202 | 846129064 | 501 (C) (3) | $27,500 | DENTAL CARE TO PATIENT WITH SPECIAL NEEDS. |
| HAWAII PRIMARY CARE ASSOCIATION | |||||||
| 735 BISHOP STREET SUITE 230 | HONOLULU | HI | 96813 | 990268275 | 501 (C) (3) | -$12,060 | REFUND FOR UNUSED GRANT AWARDED IN PRIOR YEAR. |
| LIFE FOUNDATION | |||||||
| 677 ALA MOANA BLVD SUITE 226 | HONOLULU | HI | 96813 | 990230542 | 501 (C) (3) | $30,000 | CARE AND PREVENTION OF HIV/AIDS PATIENTS. |
| SHRINERS HOSPITAL FOR CHILDREN (HONOLULU) | |||||||
| 1310 PUNAHOU STREET | HONOLULU | HI | 96826 | 362193608 | 501 (C) (3) | $41,500 | CARE TO CHILDREN WITH SPECIAL NEEDS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 10 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE I | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THERE IS A FORMAL PROCESS FOR APPLICANTS TO REQUEST GRANTS FROM THE FOUNDATION. APPLICANTS NEED TO SUBMIT PURPOSE AND PROPOSED BUDGET FOR GRANTS AND PROOF OF EXEMPT STATUS. AT THE END OF THE YEAR, APPLICANTS WHO RECEIVED GRANTS ARE REQUIRED TO SUBMIT A REPORT OF HOW THE GRANT WAS SPENT. REQUESTS FOR GRANTS ARE REVIEWED BY THE VICE PRESIDENT AND SUBMITTED TO BOARD OF TRUSTEES FOR APPROVAL. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHERYL TAKITANI-SMITH | ||||||||||||||
| TREASURER | $0 | $190,261 | $0 | $61,000 | $0 | $159 | $0 | $77,766 | $0 | $15,075 | $0 | $344,261 | $0 | $0 |
| MARK H YAMAKAWA | ||||||||||||||
| VICE PRESIDENT | $0 | $360,063 | $0 | $140,000 | $0 | $5,509 | $0 | $57,887 | $0 | $10,963 | $0 | $574,422 | $0 | $0 |
| KATHY FAY | ||||||||||||||
| SECRETARY | $0 | $190,261 | $0 | $61,000 | $0 | $0 | $0 | $26,980 | $0 | $11,484 | $0 | $289,725 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION DOES NOT PAY COMPENSATION TO ITS TRUSTEES OR OFFICERS. COMPENSATION FOR OFFICERS REPORTED IS FOR A RELATED ORGANIZATION, HAWAII DENTAL SERVICE (HDS). HDS CEO AND OFFICER COMPENSATION IS DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULANT WHICH IS PRESENTED TO AND APPROVED BY HDS BOARD OF DIRECTORS COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES. PERIODICALLY AN INDEPENDENT CONSULTANT IS HIRED TO REVIEW THE COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS. COMPENSATION FOR THESE POSITIONS ARE APPROVED ANNUALLY BY THE PRESIDENT AND CEO. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I & PART III, LINE 1 | ORGANIZATION'S MISSION STATEMENT THE OVERALL EXEMPT PURPOSE OF HAWAII DENTAL SERVICE FOUNDATION, AS A VEHICLE FOR HAWAII DENTAL SERVICE, IS TO PROMOTE THE WELFARE OF THE COMMUNITY AND TO CONTRIBUTE TO THE CHARITABLE AND HEALTH ISSUES OF THE COMMUNITY. TO PROMOTE AND ENCOURAGE THE BETTERMENT OF THE GENERAL HEALTH, INCLUDING BUT NOT LIMITED TO MEDICAL AND DENTAL HEALTH, OF THE PUBLIC FOR THE COMMON GOOD AND GENERAL WELFARE OF THE PEOPLE OF THE COMMUNITY. TO PROMOTE AND ADVANCE RESEARCH, EDUCATION, STUDY AND LEARNING IN THE HEALTH AREAS SUCH AS THE FIELD OF DENTISTRY, ORAL HYGIENE AND RELATED SCIENCES. TO ESTABLISH, CONDUCT, MAINTAIN, SPONSOR AND PROMOTE STUDIES OF COMMUNITY HEALTH, SUCH AS MEDICAL AND DENTAL NEEDS, STATISTICAL STUDIES OF GENERAL HEALTH, SUCH AS MEDICAL AND DENTAL, REQUIREMENTS OF THE POPULOUS AND TO INVESTIGATE AND CONDUCT PROGRAMS PROVIDING GENERAL HEALTH, SUCH AS MEDICAL AND DENTAL CARE OVER A BROAD AREA. |
| FORM 990, PART IV, LINE 12B | AUDITED FINANCIAL STATEMENTS FOR THE ORGANIZATION ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF HAWAII DENTAL SERVICE, HAWAII DENTAL SERVICE FOUNDATION, AND HAWAII CLIENT SERVICES CORPORATION, YEARS ENDED DECEMBER 31, 2016 AND 2015. THE AUDIT COMMITTEE OF HAWAII DENTAL SERVICE, WHICH CONSISTS OF BOARD MEMBERS, SELECTS THE AUDITORS AND REVIEWS THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| FORM 990, PART VI, SECTION A, LINE 6 | DESCRIPTION OF MEMBERS MEMBERS OR TRUSTEES OF THE HAWAII DENTAL SERVICE FOUNDATION ARE: -LIMITED TO INDIVIDUALS WHO SERVE AS DIRECTORS OF HAWAII DENTAL SERVICE -ALSO THE GOVERNING BODY OF THE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | DESCRIBE CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE HDS FOUNDATION MEMBERSHIP, WHICH IS COMPRISED OF THE MEMBERS OF THE HAWAII DENTAL SERVICE BOARD OF DIRECTORS, ANNUALLY SETS THE NUMBER (CANNOT BE LESS THAN THREE) AND ELECTS THE TRUSTEES TO SERVE ON THE HAWAII DENTAL SERVICE FOUNDATION BOARD OF TRUSTEES FOR THE ENSUING YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11B | DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE RETURN IS THOROUGHLY REVIEWED BY THE CONTROLLER OF HAWAII DENTAL SERVICE PRIOR TO FINAL REVIEW WITH THE TREASURER AND VICE PRESIDENT OF HDS FOUNDATION. A COPY OF THE FORM 990 IS PROVIDED TO THE TRUSTEES FOR REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PURSUANT TO THE HAWAII DENTAL SERVICE COMPANIES CONFLICTS OF INTEREST POLICY, TRUSTEES ARE PROVIDED WITH THE CONFLICTS OF INTEREST POLICY AND ARE REQUIRED TO SUBMIT A CONFLICTS OF INTEREST DISCLOSURE STATEMENT AND CERTIFICATION ANNUALLY. TRUSTEES ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS OR VOTE ON ISSUES/TRANSACTIONS WHICH THEY HAVE A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION THE FOUNDATION DOES NOT PAY COMPENSATION TO ITS TRUSTEES OR OFFICERS. COMPENSATION FOR OFFICERS REPORTED IS FOR A RELATED ORGANIZATION, HAWAII DENTAL SERVICE (HDS). HDS CEO AND OFFICER COMPENSATION IS DETERMINED BASED ON ADVICE FROM AN INDEPENDENT COMPENSATION CONSULANT WHICH IS PRESENTED TO AND APPROVED BY HDS BOARD OF DIRECTOR'S COMPENSATION COMMITTEE AND DOCUMENTED IN THE MINUTES. COMPENSATION FOR MANAGEMENT AND STAFF POSITIONS ARE EVALUATED AND DETERMINED BASED ON EMPLOYERS COUNCIL SURVEYS AND APPROVED BY THE PRESIDENT AND CEO ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF REQUIRED DOCUMENTS: TAX RETURNS AND OTHER REQUIRED DOCUMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 700 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 990107971 | EIN |
| Primary Activities | DENTAL PLAN PROVIDER | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(4) | ExemptCodeSectionTxt |
| Public Charity Status | N/A | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII CLIENT SERVICES CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 BISHOP STREET SUITE 710 | AddressLine1Txt |
| City | HONOLULU | CityNm |
| State Abbreviation | HI | StateAbbreviationCd |
| ZIP | 96813 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452740308 | EIN |
| Primary Activities | ADMIN SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | HI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HAWAII DENTAL SERVICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |