2016-11-08T09:02:50-06:00 2015-12-31 910189318 Moss Adams LLP 999 Third Avenue Suite 2800 Seattle WA 98104 990 2015-01-01 472335650 glassybaby white light fund GLAS 2065189060 3406 E Union Street Seattle WA 98122 David Robinson Executive Director 2065189060 2016-11-07 1 Angela M Fidler P01254538 2063026500 2016-11-03 2015 2017-02-10 21:41:12Z DAVID ROBINSON 3406 E Union Street Seattle WA 98122 819136 0 X www.glassybabywhitelightfund.org X 2014 WA PROVIDE FINANCIAL AND EMOTIONAL ASSISTANCE TO THOSE IN NEED IN ORDER TO PROMOTE HOPE AND HEALING. 6 6 0 6 0 0 0 819136 0 0 0 0 0 -85011 0 734125 0 295844 0 0 0 0 0 0 0 0 4325 0 300169 0 433956 0 433956 0 0 0 433956 glassybaby's mission is to provide financial and emotional assistance to those in need, in order to promote hope and healing. 0 0 295844 295844 The organization promotes healing, wellness, and hope through the support of organizations and programs that assist those in need. 10% from the sale of every glassybaby will be donated directly to glassybaby white light fund to give financial and emotional assistance to those in need. AS OF DECEMBER 31, 2015, GLASSYBABY WHITE LIGHT FUND IN CONJUNCTION WITH GLASSYBABY HAS PROVIDED COMMUNITY SUPPORT OF OVER $4,500,000. 295844 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 1 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 AR CA IL MA MI NY OR TX WA X David Robinson 2065189060 3406 E Union Street Seattle WA 98122 X Alison Urkowitz President 1.00 40.00 X X 0 0 0 Lee Rhodes Vice President 1.00 40.00 X X 0 0 0 Barry Harmon Secretary/Treasurer 1.00 40.00 X X 0 0 0 Anjette del Valle Director 1.00 40.00 X 0 0 0 Kristine Griffin Director 1.00 40.00 X 0 0 0 Charlotte Wayte Director 1.00 40.00 X 0 0 0 David Robinson Executive Director 5.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 125273 693863 66000 819136 0 125273 85011 -85011 -85011 734125 0 0 -85011 295844 295844 862 862 2625 2625 635 635 203 203 300169 295844 4325 0 0 433956 0 433956 0 0 X 0 0 0 0 0 433956 0 433956 0 433956 433956 0 X 0 0 0 X 819136 819136 819136 819136 743353 75783 819136 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Light the Bridge 125273 125273 19011 66000 125273 125273 19011 66000 85011 -85011 1 American Cancer Society Inc 250 Williams Street NW Suite 400 Atlanta GA 30303 131788491 501(c)(3) 12343 General Program Service Contribution American Red Cross 2025 E Street NW Washington DC 20006 530196605 501(c)(3) 10000 General Program Service Contribution Angel Flight of New England Inc 492 Sutton St Lawrence Airport North Andover MA 01845 043314346 501(c)(3) 5963 General Program Service Contribution Community Foundation of North Central Washington 9 South Wenatchee Avenue Wenatchee WA 98801 911349486 501(c)(3) 23135 General Program Service Contribution Angel Flight West Inc 3161 Donald Douglas Loop South Santa Monica CA 90405 953956297 501(c)(3) 5800 General Program Service Contribution Family Law CASA of King County 810 Third Avenue Suite 700 Seattle WA 98104 141840620 501(c)(3) 30276 General Program Service Contribution Seattle Children's Hospital and Research Foundation 4800 Sand Point Way NE Seattle WA 98105 911156519 501(c)(3) 15708 General Program Service Contribution Puget Sound VA 1660 South Columbian Way Seattle WA 98108 GOVERNMENT 63930 General Program Service Contribution The Fieldhouse Project PO Box 85432 Seattle WA 98145 463876181 501(c)(3) 6000 General Program Service Contribution United Way Worldwide 701 North Fairfax Street Alexandria VA 22314 131635294 501(c)(3) 5486 General Program Service Contribution Fred Hutchinson Cancer Research Center 1100 Fairview Avenue North Seattle WA 98109 237156071 501(c)(3) 6152 General program service contribution Camp Korey 28901 NE Carnation Farm Road Carnation WA 98014 203829742 501(c)(3) 5904 General Program Service Contribution San Francisco VA Voluntary Service 135 4150 Clement Street San Francisco CA 94121 GOVERNMENT 7660 General Program Service Contribution 13 0 Part I, Line 2: Each of the white light Fund's grants generally will be governed by an award letter or grant agreement that establishes its terms and conditions and restricting the use of grant funds for charitable purposes. As of yet, the Fund has not developed a form of grant agreement or award letter that it may use for its grants. The Fund may require grantees to prepare and submit reports to the Fund concerning expenditure of the grant funds and progress toward achievement of outcomes, depending on the size and nature of the grant and the scope of any project funded by the grant. X glassybabies - votive candle holders 1500 66000 FMV 0 0 0 Form 990, Part VI, Section A, line 2 glassybaby, LLC is the sole member of the glassybaby white light fund. Board members for glassybaby white light fund are compensated by glassybaby, LLC as employees, and may perform similar duties in their positions at the related organization. Form 990, Part VI, Section A, line 6 glassybaby is the sole corporate member of the fund. Form 990, Part VI, Section A, line 7a Under the fund's bylaws, glassybaby, llc as a corporate member, has the right to appoint and remove the directors of the Glassybaby White Light Fund. Form 990, Part VI, Section A, line 8b The organization does not have committees. Form 990, Part VI, Section B, line 11 The Form 990, including the Schedule B, is reviewed by the board and executive director before filing with the IRS. Form 990, Part VI, Section B, line 12c The purpose of this Conflict of Interest Policy (the "Policy") is to protect the interests of Glassybaby White Light Fund (the "Fund") in connection with any transaction or arrangement that might benefit the private interests of any Covered Person, as defined below. This Policy provides (i) a systematic mechanism for disclosing and evaluating potential and actual conflicts; and (ii) procedures for the Board of Directors or a committee with Board-delegated authority in considering any transaction or arrangement where a conflict may exist. This Policy is intended to supplement, but not replace, any applicable state and federal laws governing conflicts of interest applicable to nonprofit corporations. This policy addresses transactions and arrangements involving the Fund's directors, officers, members of any committee of the Fund's Board of Directors with authority to act on behalf of the Board of Directors, and the Fund's executive employees (e.g., Executive Director, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer) and any other manager or supervisor identified by the Board of Directors or the President as exercising substantial influence over the operations of the Fund ("Covered Persons"). Every Covered Person shall sign a statement that affirms that he or she has received a copy of this Policy, has read and understands it, and has agreed to comply with it, and shall complete the questionnaire attached hereto disclosing his or her actual and potential conflicts of interest on an annual basis. Each Covered Person shall promptly and fully disclose all material facts of every actual or potential conflict of interest: (i) Existing at the time when he/she becomes a Covered Person; (ii) That arises while he/she is a Covered Person, at the time such actual or potential conflict arises; and (iii) Annually through the annual Conflict of Interest Questionnaire, a copy of which is attached hereto. All disclosures involving a transaction or arrangement being considered at a meeting of the Board of Directors or a committee shall be made to all members present at such meeting. All other disclosures shall be made to the President (who shall disclose his or her conflicts to the Board of Directors). A Covered Person who is in doubt as to the existence of a conflict of interest is encouraged to disclose all facts pertaining to the transaction or arrangement before undertaking the transaction or arrangement or making any decision in the matter. (i) The President shall disclose to the Board of Directors all conflicts of interest repprted to him or her under this Policy. The Board of Directors will evaluate the disclosures and the material facts relating to the transaction or arrangement giving rise to the potential conflict of interest to determine whether they involve actual conflicts of interest and may attempt to develop alternatives to remove the conflict from the transaction or arrangement. The Board of Directors may, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. (ii) A Covered Person who has an actual or potential conflict of interest shall not be present for or shall leave any portion of a meeting at which the Board of Directors or a committee is voting to determine whether a conflict exists, but may be present prior to the vote to make a presentation to the Board or committee, to disclose additional facts, or to respond to questions. (iii) In any case in which a Covered Person has a position as a director, trustee or officer of a Grant Applicant, the Board of Directors shall not be required to evaluate whether there is an actual or potential conflict of interest. The Covered Person who serves in such position shall not be present for and shall not participate (other than to answer questions raised by the disinterested directors or committee members) in any portion of a meeting of the Board of Directors or a committee appointed by the Board at which a grant to, or any other action concerning the Grant Applicant, is considered. This provision is intended to avoid conflicts in fiduciary obligations of the Covered Person owed to the Grant Applicant and to avoid any appearance of impropriety. Formal Approval. The Fund may enter into a transaction or arrangement in which a Covered Person has a conflict of interest if: (i) The Covered Person has disclosed the conflict of interest in accordance with this Policy; (ii) A majority of directors who have no interest in the transaction or arrangement approve the transaction or arrangement at a Board or committee meeting after determining, in good faith and after reasonable investigation, that the transaction or arrangement is fair and reasonable to the Fund and is in the Fund's best interest; (iii) Any Covered Person who has an actual or potential conflict with respect to the transaction or arrangement does not participate in and is not present for the vote regarding any such transaction or arrangement (provided, however, that any such Covered Person may appear at a meeting to answer questions concerning the transaction or arrangement); and (iv) In any arrangement or-transaction involving compensation, remuneration or other economic or financial benefit to the Covered Person, the Board of Directors relies upon appropriate comparability data, such as an independent appraisal or an independent compensation study, in reaching its determination as to the fairness and reasonableness of the transaction or arrangement to the Fund. Form 990, Part VI, Section B, line 15 NO COMPENSATION WAS PAID BY THE FILING ORGANIZATION TO ANY OFFICER OR KEY EMPLOYEE IN 2015. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest, and Form 990 are available upon request. GLASSYBABY LLC 624 S Lander Street Seattle WA 98134 900187688 Glass Products WA N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0