clinton foundation · the alliance for a healthier generation, an affiliated entity, founded by the...
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November 15, 2017 Dear Reader: At the Clinton Foundation, our goal is simple – improve lives around the world and here in the United States. For over sixteen years, we have launched programs to make progress on some of the world’s most pressing challenges – for example, making HIV/AIDS treatment more affordable, combating climate change and promoting renewable energy, and fighting the opioid epidemic. In 2016, we continued our efforts to improve lives wherever we work. Some examples of the progress our programs made last year include:
The Clinton Development Initiative grew its smallholder farmer outreach in Rwanda, Malawi, and Tanzania, helping more than 150,000 farmers through 2016 by providing critical training, as well as seeds and fertilizer, to increase their yields and incomes;
The Clinton Climate Initiative continued assisting with the development of renewable energy projects across the Caribbean, including a 3 MW solar project and a 30 MW geothermal project in Saint Lucia that are expected to bring clean power to half of the country’s households;
The Clinton Health Matters Initiative continued its efforts to fight the opioid epidemic in the U.S., negotiating a groundbreaking agreement with Adapt Pharma to provide the first nasal spray version of naloxone, a drug that can reverse opioid overdoses, to all U.S. high schools free of charge;
As part of our efforts to promote early childhood development, Too Small to Fail launched a new effort to distribute books to underserved families through diaper banks, opened 21 “Talking is Teaching” themed playgrounds around the country, and distributed more than 839,000 books to underserved communities in the United States through 2016;
The Clinton Giustra Enterprise Partnership continued its work to help smallholder farmers, fishers, women entrepreneurs, and youth around the world improve their livelihoods through social enterprises, expanding its efforts to connect smallholder farmers with high-value markets in 2016;
The Clinton Global Initiative (CGI) convened a wide range of leaders through CGI America, CGI University and, after 11 years, CGI’s final Annual Meeting, which concluded with over 3,600 Commitments to Action made by CGI members that have improved the lives of more than 435 million people in more than 180 countries;
The Clinton Foundation in Haiti supported increased production of important crops such as moringa, peanuts, and castor for thousands of farmers, and joined with members of the CGI Haiti Action Network to mobilize relief in the wake of Hurricane Matthew;
No Ceilings: the Full Participation Project – together with Vital Voices Global Partnership and WEConnect International – launched a new coalition of 30 partners from the public and private sectors that seeks to increase women’s economic participation, address violence against girls and women, and promote women’s leadership;
The Alliance for a Healthier Generation, an affiliated entity, founded by the Clinton Foundation and the American Heart Association, continued its efforts to empower kids to develop lifelong healthy habits through its work in schools, juvenile justice facilities, and out-of-school time sites, reaching more than 21 million young people through 2016 in nearly 35,000 schools and more than 2,600 out-of-school time sites;
The Clinton Presidential Center in Little Rock continued to offer a variety of educational programs, special events, exhibitions, and lectures, including the Presidential Leadership Scholars program that is jointly run with the George W. Bush Presidential Center, the George H. W. Bush Presidential Library Foundation, and the Lyndon Baines Johnson Foundation; by the end of 2016 the Clinton Presidential Center had welcomed more than four million visitors, including 327,600 students and teachers who have visited the Clinton Presidential Center free of charge.
As has been previously reported this year, we saw a decline in revenue in 2016 that we had anticipated. Part of this is attributable to closing out the endowment campaign that ended in 2015, which has helped make our programs more sustainable. In addition, starting in 2015 when Secretary Clinton launched her presidential campaign, we voluntarily adopted restrictions on fundraising. But, as the examples of our progress listed above demonstrate, our programs’ strong work continued in 2016 – and right into 2017. As an operating foundation that implements our charitable programs directly and with partners, we are grateful to our donors who make this life-changing work possible. And, as part of our continued commitment to transparency and accountability, we disclose the names of our over 330,000 donors on our website. Every year, we make our Form 990 and audited financial statement available to the public to view. For reporting purposes, the latter statement also reflects the work of the Clinton Health Access Initiative, a separate 501(c)3 which became independent in 2010. The Clinton Foundation’s model has continued to be affirmed as effective by independent philanthropic watchdogs. In the last few months, three charity evaluators have awarded the Clinton Foundation top ratings – Charity Navigator renewed its ranking of four out of four stars; GuideStar renewed the Foundation's Platinum rating; and the Better Business Bureau accredited the Clinton Foundation as meeting all 20 of the BBB’s standards for governance, effectiveness, finance, and fundraising. In addition, the American Institute of Philanthropy’s “Charity Watch” has awarded the Clinton Foundation an “A” rating for its financial performance. We at the Clinton Foundation are excited about the future, and committed to continuing our efforts to improve lives everywhere we work.
Sincerely,
Kevin Thurm Acting CEO, Clinton Foundation
Bill, Hillary & Chelsea Clinton Foundation
Consolidated Financial Statements (With Supplementary Information) and Independent Auditor's Report
December 31, 2016 and 2015
Bill, Hillary & Chelsea Clinton Foundation
Index
1
Page
Independent Auditor's Report 2
Financial Statements
Consolidated Statements of Financial Position 4
Consolidated Statements of Activities 5
Consolidated Statements of Cash Flows 6
Notes to Consolidated Financial Statements 7
Supplementary Information
Consolidating Statement of Financial Position 30
Consolidating Statement of Activities 31
2
Independent Auditor's Report
To the Board of Directors Bill, Hillary & Chelsea Clinton Foundation
We have audited the accompanying consolidated financial statements of Bill, Hillary & Chelsea Clinton Foundation (the "Clinton Foundation"), which comprise the consolidated statement of financial position as of December 31, 2016, and the related consolidated statements of activities and cash flows for the year then ended, and the related notes to the consolidated financial statements.
Management's Responsibility for the Financial Statements
Management is responsible for the preparation and fair presentation of these consolidated financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation, and maintenance of internal control relevant to the preparation and fair presentation of consolidated financial statements that are free from material misstatement, whether due to fraud or error.
Auditor's Responsibility
Our responsibility is to express an opinion on these consolidated financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free from material misstatement.
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the consolidated financial statements. The procedures selected depend on the auditor's judgment, including the assessment of the risks of material misstatement of the consolidated financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity's preparation and fair presentation of the consolidated financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity's internal control. Accordingly, we express no such opinion. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements.
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.
Opinion
In our opinion, the 2016 consolidated financial statements referred to above present fairly, in all material respects, the financial position of Bill, Hillary & Chelsea Clinton Foundation as of December 31, 2016, and the changes in its net assets and its cash flows for the year then ended in accordance with accounting principles generally accepted in the United States of America.
Prior Year Consolidated Financial Statements
The consolidated financial statements of the Clinton Foundation as of and for the year ended December 31, 2015, were audited by other auditors whose report, dated November 15, 2016, expressed an unmodified opinion on those statements.
3
Report on Supplementary Information
Our audit was conducted for the purpose of forming an opinion on the 2016 consolidated financial statements as a whole. The consolidating supplementary information on pages 30 and 31 is presented for purposes of additional analysis of the consolidated financial statements, rather than to present the financial position, results of operations or cash flows of the individual entities and is not a required part of the consolidated financial statements. Such information is the responsibility of management and was derived from and relates directly to the underlying accounting and other records used to prepare the consolidated financial statements. The information has been subjected to the auditing procedures applied in the audit of the 2016 consolidated financial statements and certain additional procedures, including comparing and reconciling such information directly to the underlying accounting and other records used to prepare the consolidated financial statements or to the consolidated financial statements themselves, and other additional procedures in accordance with auditing standards generally accepted in the United States of America. In our opinion, the information is fairly stated in all material respects in relation to the consolidated financial statements taken as a whole.
New York, New York November 15, 2017
Bill, Hillary & Chelsea Clinton Foundation
Consolidated Statements of Financial Position December 31, 2016 and 2015
See Notes to Consolidated Financial Statements.
4
2016 2015
Cash and cash equivalents 14,500,941$ 37,546,683$
Assets limited as to use 80,824,510 88,009,808
Accounts receivable 1,791,007 3,498,992
Grants receivable 6,230,055 2,881,923
Loan receivable 889,273 -
Prepaid expenses and other 7,702,349 3,940,627
Contributions receivable, net 54,765,021 84,063,928
Investments 159,639,998 128,652,538
Programmatic and other investments 2,805,283 2,284,027
Assets held for sale - 2,678,966
Property and equipment, net 97,090,501 102,148,028
Total 426,238,938$ 455,705,520$
Liabilities
Accounts payable and accrued expenses 11,970,751$ 13,654,124$
Deferred revenue 24,942,244 35,883,773
Total liabilities 36,912,995 49,537,897
Commitments and contingencies
Net assets
Unrestricted 33,712,090 49,231,128
Unrestricted, invested in fixed assets 97,090,501 102,148,028
Total unrestricted 130,802,591 151,379,156
Temporarily restricted 76,448,567 71,173,749
Permanently restricted 182,074,785 183,614,718
Total net assets 389,325,943 406,167,623
Total 426,238,938$ 455,705,520$
Assets
Liabilities and Net Assets
Bill, Hillary & Chelsea Clinton Foundation
Consolidated Statements of Activities Years Ended December 31, 2016 and 2015
See Notes to Consolidated Financial Statements.
5
Temporarily Permanently Temporarily Permanently
Unrestricted restricted restricted Total Unrestricted restricted restricted Total
Revenue and support
Contributions 22,536,905$ 108,400,797$ 4,507,787$ 135,445,489$ 24,857,344$ 123,680,344$ 33,964,268$ 182,501,956$
Grants 81,153,172 - - 81,153,172 109,918,387 - - 109,918,387
Investment return 1,470,897 8,209,715 - 9,680,612 232,879 897,222 - 1,130,101
Presidential Center 3,781,783 - - 3,781,783 3,826,693 - - 3,826,693
Other income 2,797,413 699,634 - 3,497,047 1,407,966 48,709 - 1,456,675
Net assets released from restrictions 110,448,251 (110,448,251) - - 115,337,421 (115,337,421) - -
Total revenue and support 222,188,421 6,861,895 4,507,787 233,558,103 255,580,690 9,288,854 33,964,268 298,833,812
Expenses and losses
Program services 209,507,541 - - 209,507,541 226,775,644 - - 226,775,644
Management and general 27,937,134 - - 27,937,134 29,239,881 - - 29,239,881
Fund raising 5,320,311 - - 5,320,311 7,208,712 - - 7,208,712
Provision for uncollectible pledges - 1,587,077 6,047,720 7,634,797 - 357,665 1,042,955 1,400,620
Total expenses and losses 242,764,986 1,587,077 6,047,720 250,399,783 263,224,237 357,665 1,042,955 264,624,857
Change in net assets (20,576,565) 5,274,818 (1,539,933) (16,841,680) (7,643,547) 8,931,189 32,921,313 34,208,955
Net assets, beginning 151,379,156 71,173,749 183,614,718 406,167,623 159,022,703 62,242,560 150,693,405 371,958,668
Net assets, end 130,802,591$ 76,448,567$ 182,074,785$ 389,325,943$ 151,379,156$ 71,173,749$ 183,614,718$ 406,167,623$
2016 2015
Bill, Hillary & Chelsea Clinton Foundation
Consolidated Statements of Cash Flows Years Ended December 31, 2016 and 2015
See Notes to Consolidated Financial Statements.
6
2016 2015
Cash flows from operating activities
Change in net assets (16,841,680)$ 34,208,955$ Adjustments to reconcile change in net assets to net cash
provided by (used in) operating activities
Depreciation and amortization 6,156,574 6,170,235
Loss (gain) on sales of property and equipment 695,214 (4,558)
Provision for bad debts 7,634,797 1,400,620
Net realized gains on programmatic and other investments (401,556) -
Net unrealized programmatic and other investment loss (gain) (3,827,288) 2,783,842
Contributions to endowment (24,583,334) (53,515,223)
Changes in operating assets and liabilities
Assets limited as to use 7,185,298 (5,040,703)
Accounts receivable 1,707,985 (445,413)
Grants receivable (3,348,132) 6,999,043
Contributions receivable 21,664,110 26,572,438
Prepaid expenses and other (3,761,722) (344,700)
Accounts payable and accrued expenses (1,683,373) (13,914)
Deferred revenue (10,941,529) (17,994,815)
Net cash provided by (used in) operating activities (20,344,636) 775,807
Cash flows from investing activitiesPurchase of property and equipment (1,384,530) (3,054,330) Proceeds from sales of property and equipment 2,269,235 13,321
Purchases of securities and investments (93,558,540) (243,954,740)
Sales of securities and investments 66,278,668 187,099,204
Disbursements on loan receivable (889,273) -
Net cash used in investing activities (27,284,440) (59,896,545)
Cash flows from financing activities
Contributions to endowment 24,583,334 53,515,223
Net cash provided by financing activities 24,583,334 53,515,223
Net decrease in cash and cash equivalents (23,045,742) (5,605,515)
Cash and cash equivalents, beginning 37,546,683 43,152,198
Cash and cash equivalents, end 14,500,941$ 37,546,683$
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
7
Notes 1 - Nature of operations and summary of significant accounting policies
Nature of operations Bill, Hillary & Chelsea Clinton Foundation ("Clinton Foundation") works with businesses, governments, Non-Governmental Organizations ("NGO"), and individuals to improve global health and wellness, increase opportunity for girls and women, reduce childhood obesity, create economic opportunity and growth, and help communities address the effects of climate change by implementing programs, facilitating opportunities and forming creative partnerships.
To accomplish its goals through measurable results, the Clinton Foundation has established separate initiatives, with distinct approaches and missions. Each initiative reflects the Clinton Foundation’s vision and overall goals.
The initiatives are as follows:
The Alliance for a Healthier Generation ("Alliance"), an independent affiliated entity, founded by the Clinton Foundation and the American Heart Association, empowers kids to develop lifelong, healthy habits by ensuring the environments that surround them provide and promote good health. In 2016, the Alliance continued its efforts to empower kids to develop lifelong healthy habits through its work in schools, juvenile justice facilities, and out-of-school time sites.
The Clinton Climate Initiative ("CCI") collaborates with governments and partners to increase the resiliency of communities facing climate change by creating and implementing replicable and sustainable models that foster cross-sector collaborations. CCI’s approach addresses major sources of greenhouse gas emissions by bringing together relevant partners, while also saving money for individuals and governments and growing economies. In 2016, CCI continued assisting with the development of renewable energy projects across the Caribbean. To magnify the long-term impact of these efforts, in February 2016, CCI launched a new Women in Renewable Energy ("WIRE") Network so that more women are empowered to become part of the energy solutions in their communities – and to reaffirm the Clinton Foundation's commitment to the full participation of girls and women.
The Clinton Development Initiative ("CDI") develops and operates agribusiness projects that empower smallholder farmers to increase their economic potential. In Malawi, Tanzania, and Rwanda, CDI performs outreach to smallholder farmers to increase access and help them to participate equitably in local markets. CDI’s model puts farmers first by providing them training, as well as increasing their access to inputs to improve their crop yields and increase their incomes. In 2016, CDI grew its smallholder farmer outreach in Rwanda, Malawi, and Tanzania, and is now helping farmers through training and by providing seeds and fertilizer to increase their yields and incomes. CDI also helped farmers in Malawi find new markets in Europe for their groundnuts and opened the first of three planned health clinics on Anchor Farm in Malawi. The clinic provides primary health care services and disease prevention.
The Clinton Foundation has been actively engaged in Haiti since 2009, focusing on economic diversification, private sector investment, and job creation to create long-term, sustainable economic development. The Clinton Foundation concentrates on creating sustainable economic growth in five priority sectors including energy, tourism, agriculture, environment, and artisans/manufacturing, where it works to develop new markets for Haitian products; to engage international companies and investors; and to strengthen local
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
8
organizations, entrepreneurs, and businesses. In 2016, the Clinton Foundation’s work in Haiti supported increased production of important crops such as moringa, peanuts, and castor, helping to improve incomes of farmers. In the aftermath of Hurricane Matthew – which devastated the country’s southern region and left an estimated 800,000 people in urgent need of emergency relief – members of the "CGI" Haiti Action Network provided emergency supplies, equipment, and services to help support the recovery effort.
The Clinton Giustra Enterprise Partnership ("CGEP") builds social businesses to generate social impact and financial returns by addressing market gaps in developing countries’ supply or distribution chains. CGEP works with smallholder farmers, fishers, women entrepreneurs, and youth to improve their livelihoods by providing the tools they need – from training and financing to technology and innovation – and bringing them into markets where they can prosper. CGEP incorporates individuals into one of three market-driven models – supply chain businesses, inclusive distribution businesses, and vocational training center businesses. Through these models, CGEP seeks to help people work themselves out of poverty. CGEP’s successful pilot programs are incorporated to form for-profit enterprise entities in which the Clinton Foundation typically holds a significant ownership position. Included in the consolidated financial statements are the following entities carrying out the work of CGEP: Acceso Fund, LLC; Acceso Worldwide Fund, Inc.; Haiti Development Fund, LLC and Acceso Peanut Enterprise Corporation, S.A.
The Clinton Global Initiative’s ("CGI") mission is to inspire, connect, and empower everyone to forge solutions to the world’s most pressing challenges. Through 2016, CGI has convened leaders from the private sector, public sector, and civil society to drive action through its unique model. Rather than directly implementing projects, CGI helps its members turn ideas into action through impactful and measurable Commitments to Action. To support the development of commitments year-round, CGI facilitates conversations, provides opportunities to identify partners, and communicates the results of the work.
The Clinton Health Access Initiative, Inc. ("CHAI"), an affiliated entity, provides solutions to the biggest challenges impeding effective health care delivery in developing countries. CHAI applies the rigorous thinking, analysis and urgency of the business world to save lives and strengthen health systems rapidly and more efficiently by improving markets for medicines and diagnostics, lowering the cost of treatment, and accelerating access to key drugs and technologies. In January 2010, CHAI became a separate nonprofit organization and continues to operate as a separate legal entity. See Note 18.
The Clinton Health Matters Initiative ("CHMI") works to improve the health and well-being of people across the U.S. by activating individuals, communities, and organizations to make meaningful contributions to the health of others. By building strategic partnerships and working across sectors, CHMI works to reduce the prevalence of preventable health outcomes and close health inequity and disparity gaps by improving access to key contributors to health for all people. In 2016, CHMI negotiated an agreement with Adapt Pharma to provide the first nasal spray version of naloxone, a drug that can reverse opioid overdoses, to all U.S. high schools free of charge. As of the end of 2016, the distributions have already begun across the U.S.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
9
The William J. Clinton Presidential Center and Park ("Presidential Center") is the home of the Little Rock offices of the Clinton Foundation; the Clinton Presidential Library and Museum; the Clinton School of Public Service, the first institution in the nation to offer a Master of Public Service ("MPS") degree; and is a managing partner of the Presidential Leadership Scholars program, a national bipartisan executive-style leadership development initiative. Additionally, the Presidential Center is a world-class educational and cultural venue offering a variety of educational programs, special events, exhibitions, and lectures, presenting a unique perspective of the work – past, present, and future – of the 42nd President of the United States, William Jefferson Clinton.
No Ceilings: The Full Participation Project is an initiative of the Clinton Foundation which aims to advance the full participation of girls and women around the world. Through a data-driven analysis on gender equality, an in-depth conversation series, innovative partnerships, and CGI commitments, No Ceilings builds an evidence-based case to chart the path forward for the full participation of girls and women in the 21st century. In 2016, No Ceilings – together with Vital Voices Global Partnership and WEConnect International – launched a new coalition of partners from the public and private sectors that seek to increase women’s economic participation, address violence against girls and women, and promote women’s leadership.
Too Small to Fail, a joint initiative of the Clinton Foundation and The Opportunity Institute, is leading a public awareness and action campaign to promote the importance of early brain and language development and to support parents with tools to talk, read, and sing with their young children from birth. Today, almost 60% of children in the U.S. start kindergarten unprepared, falling behind their peers in critical language skills. Through partnerships with pediatricians, hospitals, faith-based leaders, community-based organizations, businesses, entertainment industry leaders, and others, Too Small to Fail is meeting parents where they are to help them prepare their children for success in school and beyond. Whether at the pediatrician's office or the playground, Too Small to Fail aims to make small moments big by creating opportunities for meaningful interactions anytime, anywhere. In 2016, Too Small to Fail launched a new effort to distribute books to underserved families through diaper banks, and opened 21 "Talking is Teaching" themed playgrounds around the country that integrate learning with play – using conversational prompts that encourage parents to talk, read, and sing with their children.
William J. Clinton Insamlingsstiftelse ("Clinton Foundation Sweden" or "WJCI") works on implementing long-term solutions focused on climate change, improving health systems in the developing world, strengthening economic development around the world and fighting childhood obesity. Clinton Foundation Sweden aims to develop or implement, independently or together with others and with joint resources, long-term solutions both locally and in all parts of the world. Clinton Foundation Sweden is a separate legal non-profit Swedish entity. See Note 17.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
10
Principles of consolidation The accompanying consolidated financial statements of the Clinton Foundation incorporate the accounts of the Clinton Foundation, including the accounts of all program operating offices of the Clinton Foundation. Additionally, the consolidated financial statements include the net assets and activities of the entities which the Clinton Foundation maintains an economic interest in and financial control over including the Clinton Foundation Sweden, Acceso Worldwide Fund, Inc., Acceso Peanut Enterprise Corporation, S.A., Acacia Development Co. and CHAI. See Notes 17 and 18.
Use of estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Cash equivalents The Clinton Foundation considers all liquid investments with original maturities of three months or less to be cash equivalents. At December 31, 2016, cash equivalents consisted primarily of money market accounts with brokers. At December 31, 2016, the Clinton Foundation’s cash and assets limited as to use accounts exceeded federally insured limits by approximately $105,000,000.
Assets limited as to use The Clinton Foundation's assets limited as to use include funds designated by contribution or grant agreements to be used for a specific limited program or purpose. Assets limited as to use held by CHAI are limited under its arrangement with UNITAID, an international organization affiliated with the World Health Organization, which works to leverage price reductions for diagnostics and medicines to better treat AIDS, malaria and tuberculosis in the developing world. The assets relate to the UNITAID arrangement and may be used only for the purchase of pediatric and second-line drugs and related commodities and diagnostics for UNITAID-sponsored projects.
Investments and investment return Investments in equity securities having a readily determinable fair value and in all debt securities are carried at fair value. The Clinton Foundation has adopted the practical expedient of valuing certain alternative investments at net asset value ("NAV") per the Financial Accounting Standards Board Accounting Standards Update No. 2015-07, Fair Value Measurement (Topic 820): Disclosures for Investments in Certain Entities that Calculate Net Asset Value per Share (or its Equivalent). Investments whose fair value is measured at NAV are excluded from the fair value hierarchy, but are presented in fair value tables as a reconciling item between the hierarchy table and total investments per the consolidated statement of financial position.
Investment return includes dividend, interest and other investment income; realized and unrealized gains and losses on investments carried at fair value; and realized gains and losses on other investments.
Investment return is reflected in the consolidated statements of activities as unrestricted, temporarily restricted or permanently restricted based upon the existence and nature of any donor or legally-imposed restrictions.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
11
Receivables Receivables primarily consist of contributions and grants receivable. The Clinton Foundation receives grant support from foundations, governmental units and private entities funding specific programs or events. Since the consolidated financial statements of the Clinton Foundation are prepared on the accrual basis of accounting, all earned portions of the grants not yet received as of December 31, 2016 and 2015 have been recorded as receivables.
Contributions receivable are stated at the amount pledged by donors net of present value discounts. The Clinton Foundation provides an allowance for doubtful pledges receivable, which is based upon a review of outstanding receivables, historical collection information and existing economic conditions. Delinquent pledges receivable are written off based on the specific circumstances of the donor making the pledge.
Accounts receivable are comprised primarily of program related billings due, general deposits, travel advances and various deposits for leased facilities.
Property and equipment Property and equipment are stated at cost less accumulated depreciation. Depreciation is charged to expense primarily by the straight-line method. Leasehold improvements are amortized over the shorter of the life of the lease or the useful life of the asset.
The estimated useful lives for each major classification of property and equipment are as follows:
Building and fixtures 15 - 40 years
Leasehold improvements 4 - 20 years
Furniture and equipment 3 - 10 years
Net assets The Clinton Foundation prepares its consolidated financial statements in conformity with accounting principles generally accepted in the United States of America ("GAAP"). Net assets, revenues and releases from restriction are classified based on the existence or absence of donor-imposed restrictions. Accordingly, the net assets of the Clinton Foundation and the changes therein are classified and reported in three categories of net assets.
Unrestricted net assets are those that are not subject to donor-imposed restrictions, including the net investment in fixed assets, unrestricted gifts and unrestricted current funds.
Temporarily restricted net assets are those whose use by the Clinton Foundation is subject to donor imposed stipulations that will be satisfied either by actions of the Clinton Foundation, the passage of time or both.
Permanently restricted net assets have been restricted by donors to be maintained by the Clinton Foundation either in perpetuity or until released by specific action by the Clinton Foundation’s Board in accordance with applicable law.
Contributions Gifts of cash and other assets received without donor stipulations are reported as unrestricted revenue and net assets. Gifts received with a donor stipulation that limits their use are reported as temporarily or permanently restricted revenue and net assets. When a donor-stipulated time restriction ends or purpose restriction is accomplished, temporarily restricted net assets are
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
12
reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. Gifts that are originally restricted by the donor and for which the restriction is met in the same time period are recorded as temporarily restricted and then released from restriction.
Gifts of land, buildings, equipment and other long-lived assets are reported as unrestricted revenue and net assets unless explicit donor stipulations specify how such assets must be used, in which case the gifts are reported as temporarily or permanently restricted revenue and net assets. Absent explicit donor stipulations for the time long-lived assets must be held, expirations of restrictions resulting in reclassification of temporarily restricted net assets to unrestricted net assets are reported when the long-lived assets are placed in service.
Unconditional gifts expected to be collected within one year are reported at their net realizable value. Amounts expected to be collected in future years are recorded at the present value of estimated future cash flows. The discounts on those pledges are computed using an interest rate for the year in which the promise was received and considers market and credit risk as applicable. Subsequent years’ accretion of the discount is included in contribution revenue.
Conditional gifts depend on the occurrence of a specified future and uncertain event to bind the potential donor and are recognized as assets and revenue when the conditions are substantially met and the gift becomes unconditional. No conditional gifts or pledges for which conditions had not been substantially met were recorded in either 2016 or 2015.
Collections The collections maintained at the William J. Clinton Presidential Library and Museum are the property of the National Archives and, as such, these collections are not included on the consolidated statements of financial position of the Clinton Foundation. Furthermore, the Clinton Foundation is not responsible for the maintenance or preservation of items in the collections.
In-kind contributions In addition to receiving cash contributions, the Clinton Foundation receives in-kind contributions from various donors. It is the policy of the Clinton Foundation to record the estimated fair value of certain in-kind donations as an expense in its consolidated financial statements and similarly increase contribution revenue by a like amount. For the years ended December 31, 2016 and 2015, $1,450,769 and $3,203,904, respectively, were received as in-kind contributions.
Grants Grant support is received from foundations, governmental units and private entities funding specific programs or events. Support funded by government grants is recognized as exchange transactions as the Clinton Foundation performs the contracted services or incurs outlays eligible for reimbursement under the grant agreements. Grant activities and outlays are subject to audit and acceptance by the granting agency and, as a result of such audit, adjustments could be required.
Other income Other income includes net revenues attributable to program specific transactions, sublease rental income, gains and losses on sale of fixed assets and proceeds from speeches given by members of the Clinton family, based on contractual agreements between the Clinton Foundation and the paying organization.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
13
Income taxes The Clinton Foundation is exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Clinton Foundation is subject to federal income tax on any unrelated business taxable income. There is no tax liability due to unrelated business income. Therefore, no provision for income taxes on unrelated business income has been included in the consolidated financial statements. The consolidated for profit entities, Acceso Worldwide Fund, Inc. and Acceso Peanut Enterprise Corporation, S.A., both have net losses. It is difficult to estimate whether the tax benefit resulting from these losses will be utilized within the prescribed period as defined by pertinent tax law. Any such benefit will be recorded in the future proportionally to the tax losses utilized and is immaterial to the consolidated financial statements. Management has analyzed tax positions taken by the consolidated entities and has concluded that, as of December 31, 2016, there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability or disclosure in the consolidated financial statements.
Functional allocation of expenses The costs of supporting the various programs and other activities have been summarized on a functional basis in the consolidated statements of activities. Certain costs have been allocated among the program services, management and general and fund-raising categories based on time and effort measurements and other methods.
Deferred revenue Deferred revenue includes granted and contributed funds received in advance for delivery of program services. These amounts are recognized as revenue when earned based on the underlying agreement. Deferred revenue also includes amounts unspent under the UNITAID agreement. CHAI recognizes contribution revenue when underlying conditions are met and costs are incurred. Advances from grantors were $24,942,244 and $35,883,773 at December 31, 2016 and 2015, respectively, and are reported as deferred revenue on the consolidated statements of financial position.
Translation of non-U.S. currency amounts Assets and liabilities that have a local functional currency are translated to U.S. dollars at year-end exchange rates. Translation adjustments are recorded in expenses. Income and expense transactions are recorded at exchange rates prevailing during the year.
Property and equipment, net and other nonmonetary assets and liabilities are translated at the approximate exchange rate prevailing when the assets or liabilities are acquired. All other assets and liabilities denominated in a currency other than U.S. dollars are translated at year-end exchange rates with the transaction gain or loss recognized in other revenue and expense.
Reclassification Certain prior year amounts have been reclassified to conform to the current year presentation.
Note 2 - Assets limited as to use
Assets limited as to use represent the cash available on hand for the UNITAID Commodities Program and cash on hand restricted to expenditures for specific Clinton Foundation programs. For the years ended December 31, 2016 and 2015, assets limited as to use were $80,824,510 and $88,009,808, respectively.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
14
Note 3 - Investments and investment return
Investments at December 31, 2016 and 2015 consisted of the following:
2016 2015
Endowment and invested excess working capital
Cash and cash equivalents 11,737,900$ 11,514,049$
Mutual funds 887,918 978,661
Equity
Hedged Equit – Limited Partnership 15,358,074 12,040,574
Select Equity – Limited Partnership 41,984,831 33,708,474
Benchmark Equity – ETF 28,386,474 22,380,664
Minimum Volatility – ETF 13,408,791 11,427,968
Fixed Income
Intermediate Fund – Private Investment Fund 17,207,593 13,853,031
Strategic Fixed Income – Limited Partnership 12,490,276 10,129,407
Private Equity – Limited Partnership 2,674,527 631,904
Diversified Strategy Funds – Limited Partnership 15,503,614 11,987,806
159,639,998$ 128,652,538$
Investments are comprised of the following components:
2016 2015
Invested excess working capital 20,915,849$ 19,967,420$
Speakers' endowment 364,276 347,101
Other endowment 138,359,873 108,338,017
159,639,998$ 128,652,538$
Composition of the investment return reported in the consolidated statements of activities is as follows:
2016 2015
Interest and dividend income 3,486,223$ 1,768,462$
Unrealized and realized net gains (losses) on investments 4,872,739 (1,887,131)
Other investment income from limited partnerships 1,321,650 1,248,770
9,680,612$ 1,130,101$
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
15
Investment return excludes investment expenses of $3,168,685 and $1,729,337 for 2016 and 2015, respectively. Investment expenses are included in management and general expenses in the consolidated statements of activities.
Note 4 - Programmatic and other investments
At December 31, 2016 and 2015, programmatic investments are associated with the missions of CDI and CGEP and were comprised of the following:
2016 2015
Acceso Fund, LLC 2,397,671$ 1,840,876$
Haiti Development Fund, LLC 117,935 127,054
Due from investment entities 38,177 245,826
Other programmatic investments 251,500 -
Pre-investment capital Moyo Development Fund - 70,271
2,805,283$ 2,284,027$
The primary purpose of the programmatic investments is to further the tax exempt objectives of the Clinton Foundation and not focus on production of income or the appreciation of the asset. Like grants, these financial investments have as their primary purpose the achievement of the Clinton Foundation’s programmatic mission. These investments, which represent ownership or investment interests in other organizations, are accounted for using the equity method of accounting, and are not subject to the fair value measurement requirements in Accounting Standard Codification 958-320 due to these investments not meeting the definition of an equity security with readily determinable fair value.
The net loss on programmatic investments accounted for by the equity method for 2016 and 2015 was $1,982,217 and $1,032,191, respectively, as reported in program services.
Note 5 - Contributions and grants receivable
2016 2015
Due within one year 19,761,147$ 34,299,733$
Due in one to five years 36,075,000 48,239,913
Due in more than five years 4,950,000 7,400,000
60,786,147 89,939,646
Less
Allowance for uncollectible contributions 3,105,997 2,148,133
Unamortized discount 2,915,129 3,727,585
54,765,021$ 84,063,928$
The Clinton Foundation and CHAI receive grant support through periodic claims filed with respective funding sources, not to exceed a limit specified in the funding agreement. Grants receivable of $6,230,055 and $2,881,923 were outstanding at December 31, 2016 and 2015, respectively.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
16
Note 6 - Property and equipment
Property and equipment at December 31, 2016 and 2015 consist of the following:
2016 2015
Land 1,300,874$ 1,300,874$
Furniture and equipment 15,378,184 15,163,683
Buildings and leasehold improvements 134,009,512 133,274,605
150,688,570 149,739,162
Less accumulated depreciation and amortization 53,598,069 47,591,134
97,090,501$ 102,148,028$
In October 2015, it was determined that the Clinton Foundation no longer needed the building located at 610 President Clinton Avenue in order to meet established goals and missions. As a result, the group of assets with a net book value of $2,678,966 associated with this location was reclassified to assets held for sale. No gain or loss was recognized in 2015 due to this reclassification. The asset was sold in 2016, and a $491,593 loss was recognized.
Note 7 - Net assets
Temporarily restricted net assets Temporarily restricted net assets on December 31, 2016 and 2015 were available for the following purposes:
2016 2015
Pledges receivable 2,875,428$ 5,833,490$
CHAI initiatives 59,969,122 55,854,691
Foundation initiatives 13,604,017 9,485,568
76,448,567$ 71,173,749$
Permanently restricted net assets Permanently restricted net assets at December 31, 2016 and 2015 were restricted to the following:
2016 2015
Clinton Foundation Endowment Fund 133,286,412$ 108,828,078$
Clinton Foundation Endowment contributions receivable, net 48,538,373 74,536,640
Speaker's Endowment Fund 250,000 250,000
182,074,785$ 183,614,718$
The Clinton Foundation Endowment Fund is comprised of permanently restricted gifts received by the Clinton Foundation. The income of the endowment fund is unrestricted as to purpose.
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
17
Net assets released from restrictions Net assets were released from donor restrictions by incurring expenses satisfying the restricted purposes, by the expiration of a time restriction or by occurrence of other events specified by donors.
2016 2015
Purpose restrictions accomplished
CHAI initiatives 72,681,758$ 59,284,751$
Haiti relief and recovery 1,232,857 2,270,250
Foundation initiatives 33,756,111 46,857,960
107,670,726 108,412,961
Time restrictions expired
Collection of pledges 2,777,525 6,924,460
110,448,251$ 115,337,421$
Note 8 - Endowment
The Clinton Foundation Endowment Fund ("Endowment") consists of funds established to support the Clinton Foundation’s mission to create partnerships of great purpose to improve global health and wellness, increase opportunity for women and girls, reduce childhood obesity, create economic opportunity and growth, and help communities address the effects of climate change. In furtherance of its mission, the overall goal of the Endowment is to provide a stable source of financial support and liquidity for the mission of the Clinton Foundation. The Endowment is comprised of donor-restricted endowment funds. As required by GAAP, net assets associated with endowment funds are classified and reported based on the existence or absence of donor-imposed restrictions.
Applicable law requires that all endowment funds be classified as permanently restricted. In the Endowment, these comprise two types of funds: (1) funds that have donor restrictions requiring that they be maintained in perpetuity; and (2) funds that do not have donor restrictions as to the term for which such funds must be maintained prior to their appropriation for spending and which can be appropriated for spending by specific action of the Clinton Foundation’s Board. In the latter instance, where there is no such explicit donor restriction within the gift instrument, the Clinton Foundation has determined that it will prudentially classify the original value of a gift and any subsequent gifts made under the same instrument as permanently restricted given the totality of the circumstances of the gift. Accumulated earnings on the Endowment are classified as temporarily restricted net assets until those amounts are appropriated for expenditure by the Clinton Foundation. The Clinton Foundation makes all determinations to appropriate or accumulate donor-restricted endowment funds in a manner consistent with the standard of prudence prescribed by applicable law, including UPMIFA.
The Clinton Foundation considers the following factors in making a determination to appropriate or accumulate donor-restricted endowment funds: (1) the duration and preservation of the various funds, (2) the purposes of the Clinton Foundation and donor-restricted endowment funds, (3) general economic conditions, (4) the possible effect of inflation and deflation, (5) the expected total return from income and the appreciation of investments, (6) other resources of the Clinton Foundation, (7) the Clinton Foundation’s investment policies, and (8) where appropriate,
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
18
alternatives to spending from the donor-restricted endowment funds and the possible effects of those alternatives on the Clinton Foundation.
The composition of net assets by type of endowment fund at December 31, 2016 and 2015 was as follows:
Temporarily Permanently
Restricted Restricted Total
Donor-restricted endowment funds 5,116,636$ 182,074,785$ 187,191,421$
Total endowment funds 5,116,636$ 182,074,785$ 187,191,421$
Temporarily Permanently
Restricted Restricted Total
Donor-restricted endowment funds 97,101$ 183,614,718$ 183,711,819$
Total endowment funds 97,101$ 183,614,718$ 183,711,819$
2016
2015
Changes in endowment net assets for the years ended December 31, 2016 and 2015 were as follows:
Temporarily Permanently
Restricted Restricted Total
Endowment net assets, beginning of year 97,101$ 183,614,718$ 183,711,819$
Investment return
Investment income 3,999,082 - 3,999,082
Investment expenses (2,637,606) - (2,637,606)
Net gains (realized and unrealized) 4,204,783 - 4,204,783
5,566,259 - 5,566,259
Provision for uncollectible pledges - (6,047,720) (6,047,720)
Contributions - 4,507,787 4,507,787
Recovery of prior years' endowment temporarily restricted deficit from unrestricted net assets (546,724) - (546,724)
Endowment net assets, end of year 5,116,636$ 182,074,785$ 187,191,421$
2016
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
19
Temporarily PermanentlyRestricted Restricted Total
Endowment net assets, beginning of year 98,560$ 150,693,405$ 150,791,965$ Investment return
Investment income 2,511,171 - 2,511,171 Investment expenses (1,441,255) - (1,441,255) Net losses (realized and unrealized) (1,618,099) - (1,618,099)
(548,183) - (548,183)
Provision for uncollectible pledges - (1,042,955) (1,042,955) Contributions - 33,964,268 33,964,268 Transfer of endowment temporarily restricteddeficit to unrestricted net assets 546,724 - 546,724
Endowment net assets, end of year 97,101$ 183,614,718$ 183,711,819$
2015
Net endowment contributions receivable as of December 31, 2016 and 2015 were $48,538,373 and $74,536,640, respectively.
From time to time, the fair value of assets associated with individual donor-restricted endowment funds may fall below the value of the initial and subsequent donor gift amounts. In accordance with GAAP, when the value of endowment funds falls below initial and subsequent gift amounts, such deficiencies are classified as a reduction of unrestricted net assets. In 2015, the Clinton Foundation experienced investment losses in certain of its permanently restricted investment funds, for which income is temporarily restricted. The resulting endowment deficiency of $546,724 was transferred to unrestricted net assets as it exceeded previous unspent temporarily restricted investment gains with which it could be offset. Investment income and gains, amounting to $546,724 in 2016 with respect to these permanently restricted funds, was allocated to unrestricted net assets to recover the deficiency, and all other remaining net investment income and gains were allocated to temporarily restricted net assets.
The Endowment was created in 2013. During 2015, the Clinton Foundation Board finalized appointment of the members for the Investment Committee which is empowered to approve and adopt investment policies and procedures so that endowment funds and their related returns are spent in accordance with UPMIFA and donors’ intent and maintain the appropriate amount of risk and return for the Clinton Foundation’s purposes. For the long-term, the primary investment objective for the Endowment is to earn a total return (net of all investment program fees), within a prudent level of risk, which is sufficient to maintain in real terms the purchasing power of the Endowment, support operating expenses and payout requirements and provide moderate capital appreciation after accounting for such distributions and expenses. The risk tolerance of the Clinton Foundation is moderate. Moderate fluctuations in market value can be tolerated over time, and stability of the overall corpus is valued for predictability and consistency of payouts over time. This tolerance, as dictated by market conditions and organizational circumstances, may be adjusted over time. The Clinton Foundation’s investment time horizon is long-term. The Clinton Foundation, in consultation with the Investment Committee, has delegated to an Investment Advisor the day-to-day implementation of the investment program as set forth in the Clinton Foundation’s Investment Policy Statement. The specific roles and responsibilities of the Investment Advisor are governed by a written investment management agreement, signed and agreed to by the Clinton Foundation and the Investment Advisor.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
20
The following is a summary of the asset allocation guidelines and performance benchmarks adopted by the Clinton Foundation:
Benchmark
Near-Term Long-Term
Reserve
Reserve Fixed Income 10.00 % 10.00 % Barclays Intermediate Government/Credit Index
Balanced Reserves 2.50 0.00
Subtotal 12.50 10.00
Hedged
Strategic Fixed Income 9.00 7.00 HFRI Strategic Fixed Income Blend
Diversified Strategies 10.50 9.00 HFRI Fund of Funds Diversified Index
Hedged Equity 10.50 9.00 HRFI Equity (Total) Hedge Index
Subtotal 30.00 25.00
Directional
Benchmark Equity 25.00 25.00 MSCI All Country World Index
Select Equity 27.50 25.00 MSCI All Country World IMI Index
Private Investments 5.00 15.00 State Street Private Equity Index: US Private
Subtotal 57.50 65.00 Equity Funds Median Return
Total 100.00 % 100.00 %
Target Allocation by Asset Class
Actual allocations by major asset class are consistent with near-term targets.
The Endowment uses two different spending policies, one for the near-term and one for the long-term, to be adopted once the Clinton Foundation reaches a threshold set at the Board’s discretion. The near-term spending policy dictates that no spending will occur from the Endowment for the foreseeable future as the corpus is established and grows meaningfully from inflows. The long-term spending policy specifies that annual spending will be based on 3%-5% of the trailing 12 quarter average of the Endowment or similar formula. By using the trailing 12 quarter average the Clinton Foundation aims to smooth the spending amount and avoid large swings, providing a consistent and predictable level of financial support for the Clinton Foundation over time. The Clinton Foundation has not designated any of the endowment funds (or any net appreciation from these funds classified in temporarily restricted net assets) for spending during 2016 or 2015.
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
21
Note 9 - Functional expenses
Expenses incurred by the Clinton Foundation, excluding provision for uncollectible pledges, classified by functional categories for the years ended December 31, 2016 and 2015, were as follows:
Program Management Fund
services and general raising Total
Salaries and benefits 93,186,651$ 15,085,832$ 2,966,827$ 111,239,310$
Direct program expenditures 17,517,137 - - 17,517,137
Professional and consulting 12,433,899 3,322,949 387,159 16,144,007
Conferences and events 10,038,507 91,118 812,472 10,942,097
UNITAID commodities expense 8,884,898 - - 8,884,898
Procurement and shipping 1,102,357 - - 1,102,357
Travel 10,729,045 518,770 175,304 11,423,119
Telecommunications 2,181,975 484,062 18,712 2,684,749
Meetings and trainings 16,278,930 468,753 22,970 16,770,653
Bank and other fees 375,630 3,340,195 102,080 3,817,905
Occupancy costs 5,798,977 1,439,238 314,653 7,552,868
Office expenses 2,076,245 1,039,432 25,687 3,141,364
Capital charges 4,229,413 103,980 3,977 4,337,370
Depreciation 5,333,186 453,398 369,990 6,156,574
Grants 15,140,931 - - 15,140,931
Loss on program investments 2,279,891 - - 2,279,891
Other 1,919,869 1,589,407 120,480 3,629,756
209,507,541$ 27,937,134$ 5,320,311$ 242,764,986$
2016
Total
Program Management Fund
services and general raising Total
Salaries and benefits 91,366,133$ 15,223,518$ 2,689,242$ 109,278,893$
Direct program expenditures 11,029,245 22,235 10,000 11,061,480
Professional and consulting 18,556,362 4,545,099 759,736 23,861,197
Conferences and events 12,516,559 123,830 816,080 13,456,469
UNITAID commodities expense 8,730,210 - - 8,730,210
Procurement and shipping 2,293,257 - - 2,293,257
Travel 16,781,074 946,324 1,110,091 18,837,489
Telecommunications 2,508,234 526,888 20,481 3,055,603
Meetings and trainings 13,186,518 333,839 31,557 13,551,914
Bank and other fees 850,090 2,166,808 144,787 3,161,685
Occupancy costs 5,623,106 1,452,950 215,400 7,291,456
Office expenses 3,810,973 1,199,373 54,369 5,064,715
Capital charges 6,601,193 17,379 - 6,618,572
Depreciation 5,337,835 536,797 295,604 6,170,236
Grants 22,177,178 - - 22,177,178
Loss on program investments 2,487,036 - - 2,487,036
Other 2,920,641 2,144,841 1,061,365 6,126,847
Total 226,775,644$ 29,239,881$ 7,208,712$ 263,224,237$
2015
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
22
Note 10 - Program services expenses
Program service expenses incurred by the Clinton Foundation classified by initiative for the years ended December 31, 2016 and 2015 were as follows:
Amount Percent Amount Percent
Clinton Health Access Initiative 138,547,530$ 66 % 148,118,772$ 65 %
Clinton Global Initiative 22,812,200 11 26,830,896 12
Clinton Presidential Center 12,069,307 6 12,629,567 6
Clinton Development Initiative 10,646,666 5 6,618,505 3
Clinton Giustra Enterprise Partnership 8,720,836 4 8,191,216 4
Clinton Climate Initiative 4,404,363 2 8,628,388 3
Clinton Health Matters Initiative 3,856,731 2 3,703,878 2
Other programs 8,449,908 4 12,054,422 5
209,507,541$ 100% 226,775,644$ 100 %
2016 2015
Note 11 - Operating leases
The Clinton Foundation leases numerous office spaces, both domestically and internationally, under noncancellable operating lease agreements. These leases expire at various dates through 2043.
The future minimum lease payments under these leases are as follows:
2017 5,245,971$
2018 1,647,580
2019 1,468,639
2020 1,358,632
2021 834,606
Thereafter 4,407,614
Total 14,963,042$
Rental expense for all operating leases was $5,557,291 and $5,032,353 for 2016 and 2015, respectively.
There are three standby letters of credit totaling $1,183,490 in support of these leases. There are no amounts outstanding on the letters of credit as of December 31, 2016.
Note 12 - Pension plan
Retirement benefits are offered to the Clinton Foundation employees based on eligibility. These benefits vary and are dependent on employee type and location.
U.S.- based staff and U.S. expatriates are eligible to contribute into a 401(k) plan which the Clinton Foundation matches up to 6% of the employee contribution.
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
23
Third Country Nationals and Local national retirement plans are available in a select number of countries. The Clinton Foundation also contributes to the national social security fund in many of the countries in which it operates as stipulated by local law.
Pension expense was $4,308,115 and $4,410,939 for 2016 and 2015, respectively.
Note 13 - Transactions with the National Archives and Records Administration and lease with the City of Little Rock, Arkansas
In 2004, the Clinton Foundation entered into a joint use, operating and transfer agreement with the National Archives and Records Administration ("NARA") that expires February 29, 2101. Under the agreement, NARA agreed to operate certain areas of the facility known as the William J. Clinton Presidential Library and Museum (the "Library") for the purposes of housing, preserving and making available, through historical research, exhibitions, educational programs and other activities, the presidential records and historical materials of President William Jefferson Clinton.
Because the terms of the lease essentially transfer to NARA the right to use portions of the Library for a period in excess of the property’s expected economic life, the cost of construction of those areas operated by NARA, which amounted to approximately $36,000,000, has been excluded from the Clinton Foundation’s consolidated statements of financial position.
The land occupied by the Library is owned by the City of Little Rock, Arkansas (the "City"), but is leased to the Clinton Foundation under a 99-year lease for a nominal annual amount. The Clinton Foundation is responsible for maintaining those areas within 75 feet of the buildings and certain land improvements. Maintenance of the remaining land is the responsibility of the City. Because the lease with the City does not convey exclusive right to the use of this land and because it is to be operated in a manner similar to other City parks, the Clinton Foundation does not recognize the present value of the lease’s fair value within its consolidated financial statements.
Note 14 - Disclosures about fair value of assets
Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Fair value measurements must maximize the use of observable inputs and minimize the use of unobservable inputs. There is a hierarchy of three levels of inputs that may be used to measure fair value:
Level 1: Quoted prices in active markets for identical assets or liabilities.
Level 2: Observable inputs other than Level 1 prices, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3: Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.
Investments Where quoted market prices are available in an active market, securities are classified within Level 1 of the valuation hierarchy. Level 1 securities include money market funds, equity securities and mutual funds. If quoted market prices are not available, then fair values are estimated by using pricing models, quoted prices of securities with similar characteristics or discounted cash flows. In
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
24
certain cases where Level 1 or Level 2 inputs are not available, securities are classified within Level 3 of the hierarchy. The Clinton Foundation did not have any Level 2 or Level 3 measurements at December 31, 2016 or 2015.
The Clinton Foundation has certain alternative investments for which there is not a readily determinable fair value. These investments have financial statements consistent with the measurement principles of an investment company or have the attributes of an investment company. For such investments, as a practical expedient, the Clinton Foundation uses its ownership interest in the entity NAV to determine the fair value. These investments valued at NAV are no longer included within Levels 1, 2, or 3 in the fair value hierarchy, but are included in the fair value table for purposes of investment reconciliation to amounts in the consolidated statements of financial position.
Recurring measurements The following table presents the fair value measurements of assets and liabilities in the accompanying consolidated statements of financial position measured at fair value on a recurring basis and the NAV or level within the fair value hierarchy in which the fair value measurements fall at December 31, 2016 and 2015:
Fair Value
Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
Investments at
Net Asset Value
December 31, 2016
Investments
Cash and cash equivalents 11,737,900$ 11,737,900$ -$
Mutual funds 887,918 887,918 -
- -
Equity
Hedged Equity 15,358,074 - 15,358,074
Select Equity 41,984,831 - 41,984,831
Benchmark Equity 28,386,474 28,386,474 -
Minimum Volatility 13,408,791 13,408,791 -
Fixed Income
Intermediate Fund 17,207,593 - 17,207,593
Strategic Fixed Income 12,490,276 - 12,490,276
Private Equity 2,674,527 - 2,674,527
Diversified Strategy Fund 15,503,614 - 15,503,614
Total 159,639,998$ 54,421,083$ 105,218,915$
Fair Value Measurements Using
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
25
Fair Value
Quoted Prices in
Active Markets
for Identical
Assets (Level 1)
Investments at
net asset value
December 31, 2015
Investments
Cash and cash equivalents 11,514,049$ 11,514,049$ -$
Mutual funds 978,661 978,661 -
Equity
Hedged Equity 12,040,574 - 12,040,574
Select Equity 33,708,474 - 33,708,474
Benchmark Equity 22,380,664 22,380,664 -
Minimum Volatility 11,427,968 11,427,968 -
Fixed income
Intermediate Fund 13,853,031 - 13,853,031
Strategic fixed Income 10,129,407 - 10,129,407
Private Equity 631,904 - 631,904
Diversified Strategy Fund 11,987,806 - 11,987,806
Total 128,652,538$ 46,301,342$ 82,351,196$
Fair Value Measurements Using
The following table provides additional information about alternative investments measured at net asset value:
December 31, 2016 Net asset value
Unfunded
commitments
Redemption
frequency (if
currently eligible)
Redemption
notice period
Investments
Hedged Equity 15,358,074$ -$ Monthly 7 business days
Select Equity 41,984,831 - Monthly 7 business days
Intermediate Fund 17,207,593 - Daily 5 business days
Strategic Fixed Income 12,490,276 - Monthly 7 business days
Private Equity 2,674,527 17,244,596 No liquidity No liquidity
Diversified Strategy Funds 15,503,614 - Monthly 7 business days
105,218,915$ 17,244,596$
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Notes to Consolidated Financial Statements December 31, 2016 and 2015
26
Investment Type Redemption Restrictions (if any)
Hedged Equity Redemptions are paid out in installments over time based on the liquidity of underlying
funds. If a w ithdraw al request exceeds 20% of Portfolio's NAV it may be granted on a
pro rata basis so that no more than 20% of the NAV w ill be w ithdraw n at any given
w ithdraw al date.
Select Equity Redemptions are paid out in installments over time based on the liquidity of underlying
funds. If a w ithdraw al request exceeds 20% of Portfolio's NAV it may be granted on a
pro rata basis so that no more than 20% of the NAV w ill be w ithdraw n at any given
w ithdraw al date.
Intermediate Fund None
Strategic Fixed Income Redemptions are paid out in installments over time based on the liquidity of underlying
funds. If a w ithdraw al request exceeds 20% of Portfolio's NAV it may be granted on a
pro rata basis so that no more than 20% of the NAV w ill be w ithdraw n at any given
w ithdraw al date.
Private Equity At sole discretion of General Partner.
Diversif ied Strategy Funds Redemptions are paid out in installments over time based on the liquidity of underlying
funds. If a w ithdraw al request exceeds 20% of Portfolio's NAV it may be granted on a
pro rata basis so that no more than 20% of the NAV w ill be w ithdraw n at any given
w ithdraw al date.
Investment Type Investment Strategy
Hedged Equity The Hedged Equity Portfolio allocates capital to a number of managers w ho approach the
w orld's equity markets w ith the intention of generating positive total returns over a market
cycle, w hile also attempting to preserve capital during adverse market conditions.
Select Equity The Select Equity Portfolio allocates capital to a number of managers w ho apply their
unique insights and talents to the w orld's public equity markets. Select Equity managers
seek to exceed the return of the global public equities through research driven stock
selection, private equity approaches to public corporate shares and increased
concentration around a set of high conviction ideas.
Intermediate Fund The Fixed Income Intermediate Fund strives to add value through vigilant security selection
placing an emphasis on attractive, overlooked and ineff iciently priced issues. Dedicated
to finding bonds that offer attractive structural advantages w ith appropriate credit
exposure and a desirable risk return profile. Portfolios are comprised of U.S. fixed income
securities developed using a disciplined, bottom up investment approach.
Strategic Fixed Income The Strategic Fixed Income Portfolio allocates capital to a number of managers w ho
approach the w orld's fixed income, foreign exchange and credit markets w ith strong
research skills and/or quantitative and technical insights.
Private Equity The Private Equity Portfolio allocates capital to a number of managers w ho seek to exceed
the return of the global public equity market through value generation and operational
intensity. The underlying fund investments are generally expected to span a range of
strategies including, w ithout limitation, investments of the follow ing nature: buyout,
grow th capital, venture capital, distressed credit and direct lending. In addition, the
Portfolio intends to consider, and may include, strategies that are sector specif ic and may
be related to physical assets such as real estate and natural resources.
Diversif ied Strategy Funds The Diversif ied Strategy Portfolio allocates capital to a number of managers w ho deploy
their capital w ith flexibility across all major markets of the w orld including public equities,
f ixed income, credit foreign exchange, commodities and may, from time to time, also make
privately negotiated equity and debt investments. The composition of the portfolios
relative to actual underlying asset classes are likely to evolve over time based on the core
competencies of each underlying manager's team.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
27
The carrying amounts of cash and cash equivalents, contributions receivable, net, assets limited as to use, and accounts payable approximate fair value because of the relative short-term nature of these instruments.
Note 15 - Related party
The Clinton Foundation engages in certain charitable activities that are funded by CGEP. CGEP makes grants from time to time to the Clinton Foundation to carry out CGEP's and the Clinton Foundation’s charitable goals. Neither entity controls the other; however, they share a common board member. During 2016 and 2015, the Clinton Foundation received from CGEP $5,766,375 and $74,910, respectively.
Note 16 - Significant estimates and concentrations
Accounting principles generally accepted in the United States of America require disclosure of certain significant estimates and current vulnerabilities due to certain concentrations. These matters include the following:
Assets in foreign countries The Clinton Foundation maintains cash balances and equipment in Asia, Africa, the Caribbean, Sweden, Australia, Haiti and South America. At December 31, 2016 and 2015, the Clinton Foundation had approximately $3,100,000 and $11,800,000, respectively, deposited in foreign banks and equipment with an acquisition cost of approximately $6,900,000 and $11,900,000, respectively, in foreign countries.
Contributions and grants For the years ended December 31, 2016 and 2015, the concentration of earned revenue was as follows:
2016 2015
Government and multilaterals 35 % 40 %
Foundations 44 39
Other donors 21 21
100 % 100 %
Contribution and grant revenue recorded in the consolidated statements of activities totaled approximately $217,000,000 and $291,000,000 for the years ended December 31, 2016 and 2015, respectively.
Litigation The Clinton Foundation is, from time to time, subject to claims that arise primarily in the ordinary course of its activities. Currently, management is not aware of any such claim or claims that would have a material adverse effect on the Clinton Foundation’s consolidated financial position or net assets. Events could occur, however, that would change this estimate materially in the near term.
Bill, Hillary & Chelsea Clinton Foundation
Notes to Consolidated Financial Statements December 31, 2016 and 2015
28
Note 17 - Disposal activities
On November 29, 2016, the board of Clinton Foundation Sweden, an affiliated non-profit organization, adopted and implemented plans to end operations. As a result, Clinton Foundation Sweden ceased fund raising activities, addressed outstanding liabilities, and dissolved its operations prior to December 31, 2016. No material gains or losses arose as a result of this dissolution.
Contribution revenue for Clinton Foundation Sweden, included in the consolidated financial statements, totaled $5,800,000 and $4,400,000, respectively, for the years ended December 31, 2016 and 2015.
Note 18 - Subsequent events
Subsequent events have been evaluated through November 15, 2017, which is the date the consolidated financial statements were available to be issued.
On March 7, 2017, CHAI amended its bylaws to alter its governance structure. Prior to that date, the Clinton Foundation appointed five of CHAI's nine board members, with the remaining board members being elected by the CHAI board as a whole. Pursuant to the amendment, the CHAI board was expanded to fifteen members, five of whom are recommended by the Clinton Foundation and ten of whom are recommended by the independent board members. This slate of nominees is then elected by the CHAI board as a whole. Accordingly, subsequent to March 7, 2017, the Clinton Foundation no longer maintains an economic interest in or control of CHAI and effective March 7, 2017, CHAI will no longer be consolidated. Revenues and total assets related to CHAI were approximately $152,732,000 and $90,763,000 respectively, as of and for the year ended December 31, 2016.
Bill, Hillary & Chelsea Clinton Foundation
Consolidating Statement of Financial Position December 31, 2016
See Independent Auditor's Report.
30
Acceso Acacia Acceso Peanut Eliminations
Clinton William J.Clinton Worldwide Development Enterprise and
Foundation CHAI, Inc. Insamlingsstiftelse Fund, Inc. Co. Corporation, S.A. adjustments Consolidated
Assets
Cash and cash equivalents 11,612,637$ 2,231,644$ -$ 656,560$ 100$ -$ -$ 14,500,941$
Assets limited as to use 7,921,676 72,902,834 - - - - - 80,824,510
Accounts receivable 1,381,173 409,834 - 5,900 - - (5,900) 1,791,007
Grants receivable 138,040 6,092,015 - - - - - 6,230,055
Loan receivable 889,273 - - - - - - 889,273
Prepaid expenses and other 1,653,005 6,049,344 - - - - - 7,702,349
Contributions receivable, net 51,934,630 2,830,391 - - - - - 54,765,021
Investments 159,639,998 - - - - - - 159,639,998
Programmatic and other investments 3,467,843 - - - 250,000 - (912,560) 2,805,283
Assets held for sale - - - - - - - -
Property and equipment, net 96,843,172 247,329 - - - - - 97,090,501
Total assets 335,481,447$ 90,763,391$ -$ 662,460$ 250,100$ -$ (918,460)$ 426,238,938$
Liabilities and Net Assets
LiabilitiesAccounts payable and accrued expenses 7,466,397$ 4,510,254$ -$ -$ -$ -$ (5,900)$ 11,970,751$ Deferred revenue 1,279,854 23,662,390 - - - - - 24,942,244
Total liabilities 8,746,251 28,172,644 - - - - (5,900) 36,912,995
Net assetsUnrestricted net assets 128,180,966 2,621,625 - - - - - 130,802,591 Temporarily restricted 16,479,445 59,969,122 - 662,460 250,100 - (912,560) 76,448,567
Permanently restricted 182,074,785 - - - - - - 182,074,785
Total net assets 326,735,196 62,590,747 - 662,460 250,100 - (912,560) 389,325,943
Total 335,481,447$ 90,763,391$ -$ 662,460$ 250,100$ -$ (918,460)$ 426,238,938$
Bill, Hillary & Chelsea Clinton Foundation
Consolidating Statement of Activities Year Ended December 31, 2016
See Independent Auditor's Report.
31
Acceso Acacia Acceso Peanut Eliminations
Clinton William J.Clinton Worldwide Development Enterprise and
Foundation CHAI, Inc. Insamlingsstiftelse Fund, Inc. Co. Corporation S.A. adjustments Consolidated
Revenues and support
Contributions 57,333,947$ 78,111,542$ 5,796,904$ -$ -$ -$ (5,796,904)$ 135,445,489$
Grants 6,728,584 74,424,588 - - - - - 81,153,172
Investment return 9,680,612 - - 204,292 - - (204,292) 9,680,612
Presidential Center 3,781,783 - - - - - - 3,781,783
Other 3,300,790 196,257 71,802 (11,802) - - (60,000) 3,497,047
Total revenue and support 80,825,716 152,732,387 5,868,706 192,490 - - (6,061,196) 233,558,103
Expenses and losses
Salaries and benefits 38,281,980 72,957,330 - 47,180 - - (47,180) 111,239,310
Direct program expenditures 6,763,598 19,638,437 5,821,587 - - - (5,821,587) 26,402,035
Professional and consulting 8,160,827 7,983,180 - 12,200 1,500 - (13,700) 16,144,007
Conferences and events 10,942,097 - - - - - - 10,942,097
Procurement and shipping - 1,102,357 - - - - - 1,102,357
Travel 3,811,775 7,611,344 - - - - - 11,423,119
Telecommunications 629,412 2,055,337 - - - - - 2,684,749
Meetings and trainings 332,454 16,438,199 - - - - - 16,770,653
Bank and other fees 3,491,776 326,129 - - - - - 3,817,905
Occupancy costs 4,812,165 2,740,703 - - - - - 7,552,868
Office expenses 1,016,016 2,125,348 - - - - - 3,141,364
Capital charges 1,118,634 3,218,736 - - - - - 4,337,370
Depreciation 6,071,818 84,756 - - - - - 6,156,574
Grants 2,772,514 12,368,417 - - - - - 15,140,931
Loss on program investments 2,279,891 - - - - - - 2,279,891
Other 2,579,687 1,050,069 118,955 21,069 - - (140,024) 3,629,756
Provision for uncollectible pledges 7,634,797 - - - - - - 7,634,797
Total expenses and losses 100,699,441 149,700,342 5,940,542 80,449 1,500 - (6,022,491) 250,399,783
Change in net assets before acquisitions, dispositions, and
transactions between commonly controlled entities (19,873,725) 3,032,045 (71,836) 112,041 (1,500) - (38,705) (16,841,680)
Purchase of Acacia shares - - - - 251,600 - (251,600) -
Sale of controlling interest in APEC to Accesso Fund, LLC - - - - - (16,671) 16,671 -
Dissolution of WJCI- transfer of net assets to Clinton Foundation - - 4,763 - - - (4,763) -
Investor contributions - - - 117,946 - - (117,946) -
Change in net assets (19,873,725) 3,032,045 (67,073) 229,987 250,100 (16,671) (396,343) (16,841,680)
Shareholders' equity - - 67,073 432,473 - 16,671 (516,217) -
Net assets, beginning 346,608,921 59,558,702 - - - - - 406,167,623
Net assets, end 326,735,196$ 62,590,747$ -$ 662,460$ 250,100$ -$ (912,560)$ 389,325,943$
EXTENDED TO NOVEMBER 15, 2017
OMB No. 1545-0047
0 Return of Organization Exempt From Income Tax Form 9 9 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2 0 1 6| Do not enter social security numbers on this form as it may be made public. Department of the Treasury Open toPublic Internal Revenue Service | Information about Form 990 and its instructions is at www irs gov/form990 Inspection
A For the 2016 calendar year, or tax year beginning and
B Check if C Name of organization applicable:
BILL, HILLARY & CHELSEA CLINTON
r-ir-ir-i
Address X change FOUNDATION Name change Doing business as Initial return Number and street (or P.O. box if mail is not delivered to street address)
r-iFinal 1200 PRESIDENT CLINTON AVE return/ termin-
r-i ated City or town, state or province, country, and ZIP or foreign postal code Amended return LITTLE ROCK, AR 72201Applica- r-i tion F Name and address of principal officer: KEVIN THURM pending
SAME AS C ABOVE
Website:| WWW. CLINTONFOUNDATI ON. ORG
D Employer identification number
31-1580204
Room/suite E Telephone number 501-748-0471
G Grossreceipts$ 77,390,585.
H(a) Is thisagroup return
for subordinates?~~ r-iYes r-i X No H(b) Are all subordinates included? r-i Yes No
If No, attach a list. (see instructions)
H(c) Group exemption number | Trust r-i
Association r-i Other 1997
GAii&ittesvco
vernance
2 Check this box | r-i if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1 a) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3
4 Number of independent voting members of the governing body (Part VI, line 1 b) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4
5 Total number of individuals employed in calendar year 2016 (Part V, line 2a) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 5
6 Total number of volunteers (estima t e if necessar y ) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 6
7 a Total unrelated business revenue from Part VIII, column (C), line 12 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 7 a
1 Briefly describe the organization's mission or most significant activities: SEE SCHEDULE O.
REee
xp
en
venues s
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, 1 0c, and 11e) ~~~~~~~~ 12 Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ��� 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 fund raising fees (Part IX, column (A), line 11e) ~~~~~~~~~~~~~~
b Total fundraisi ng expenses (Part IX, column (D), line 25) | 3,348,719. 17 Other expenses (Part IX, column (A), lines 11 a-11d, 11 f-24e) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) ~ ~ ~ ~ ~ ~ ~
o r
20 Total assets (Part X, line 16) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 21 Total liabilities (Part X, line 26) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
of legal domicile:AR
10
9
578
400
2,024,689. 0.
Current Year 62,912,331.
2,912,432.
4,742,091.
209,674.
70,776,528.
2,772,514.
0.
37,360,489.
147,564.
47,134,731.
87,415,298.
-16,638,770.
End of Year 335,481,447.
8,746,251.
326,735,196.
Prior Year 108,915,463.
2,628,406.
2,894,924.
1,643,715.
116,082,508.
3,744,706.
0.
38,037,346.
569,871.
56,525,427.
98,877,350.
17,205,158.
g of Current Year 359,923,364.
13,314,443.
346,608,921.
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 = Signature of officer Date
Here ANDREW M KESSEL, CFO
_________ = Type or print name and title
Print/Type preparer's name Preparer's signature Date Check r-i PTIN i f
Paid T HOMAS LANNING T HOMAS LANNING 11/14/17 self-employed P00851654
Preparer Firm's name COHNREZNICK LLP Firm's EIN 22-1478099
Use Only Firm's address 1301 AVENUE OF THE AMERICAS
NEW YORK, NY 10019 Phone no.212-297-0400
May the IRS discuss this return with the preparer shown above? (see instructions) � � � � � � � � � � � � � � � � � � � � � r-iX Yes No 632001 11-11-16 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2016)
Checkifself-employed
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Check ifapplicable:
Addresschange
NamechangeInitialreturn
Finalreturn/termin-ated Gross receipts $
AmendedreturnApplica-tionpending
Are all subordinates included?
632001 11-11-16
Beginning of Current Year
Paid
Preparer
Use Only
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. Open to Public Inspection| Information about Form 990 and its instructions is at
A For the 2016 calendar year, or tax year beginning and ending
B C D Employer identification number
E
G
H(a)
H(b)
H(c)
F Yes No
Yes No
I
J
K
Website: |
L M
1
2
3
4
5
6
7
3
4
5
6
7a
7b
a
b
Ac
tivi
tie
s &
Go
vern
an
ce
Prior Year Current Year
8
9
10
11
12
13
14
15
16
17
18
19
Re
ven
ue
a
b
Exp
en
se
s
End of Year
20
21
22
Sign
Here
Yes No
For Paperwork Reduction Act Notice, see the separate instructions.
(or P.O. box if mail is not delivered to street address) Room/suite
)501(c)(3) 501(c) ( (insert no.) 4947(a)(1) or 527
|Corporation Trust Association OtherForm of organization: Year of formation: State of legal domicile:
|
|
Net
Ass
ets
orFu
nd B
alan
ces
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.
Signature of officer Date
Type or print name and title
Date PTINPrint/Type preparer's name Preparer's signature
Firm's name Firm's EIN
Firm's address
Phone no.
Form
Name of organization
Doing business as
Number and street Telephone number
City or town, state or province, country, and ZIP or foreign postal code
Is this a group return
for subordinates?Name and address of principal officer: ~~
If "No," attach a list. (see instructions)
Group exemption number |
Tax-exempt status:
Briefly describe the organization's mission or most significant activities:
Check this box 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 1a)
Number of independent voting members of the governing body (Part VI, line 1b)
Total number of individuals employed in calendar year 2016 (Part V, line 2a)
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
Total number of volunteers (estimate if necessary)
Total unrelated business revenue from Part VIII, column (C), line 12
Net unrelated business taxable income from Form 990-T, line 34
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
����������������������
Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~
Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ���
Grants and similar amounts paid (Part IX, column (A), lines 1-3)
Benefits paid to or for members (Part IX, column (A), line 4)
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
~~~~~~~~~~~
~~~~~~~~~~~~~
~~~
Professional fundraising fees (Part IX, column (A), line 11e)
Total fundraising expenses (Part IX, column (D), line 25)
~~~~~~~~~~~~~~
Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 18 from line 12
~~~~~~~~~~~~~
~~~~~~~
����������������
Total assets (Part X, line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
��������������
May the IRS discuss this return with the preparer shown above? (see instructions) ���������������������
LHA Form (2016)
www.irs.gov/form990.
Part I Summary
Signature BlockPart II
990
Return of Organization Exempt From Income Tax990 2016
§
==
999
EXTENDED TO NOVEMBER 15, 2017
XBILL, HILLARY & CHELSEA CLINTONFOUNDATION
31-1580204
501-748-04711200 PRESIDENT CLINTON AVE77,390,585.
LITTLE ROCK, AR 72201XKEVIN THURM
WWW.CLINTONFOUNDATION.ORGX 1997 AR
SEE SCHEDULE O.
109
578400
2,024,689.0.
62,912,331.2,912,432.4,742,091.209,674.
116,082,508. 70,776,528.2,772,514.
0.37,360,489.
147,564.3,348,719.
47,134,731.98,877,350. 87,415,298.17,205,158. -16,638,770.
359,923,364. 335,481,447.13,314,443. 8,746,251.346,608,921. 326,735,196.
ANDREW M KESSEL, CFO
THOMAS LANNING 11/14/17 P00851654THOMAS LANNING22-1478099COHNREZNICK LLP
1301 AVENUE OF THE AMERICASNEW YORK, NY 10019 212-297-0400
X
SAME AS C ABOVEX
108,915,463.2,628,406.2,894,924.1,643,715.
3,744,706.0.
38,037,346.569,871.
56,525,427.
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 2 Part III I Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III .................................................................................... X 1 Briefly describe the organization's mission:
THE CLINTON FOUNDATION WORKS TO IMPROVE GLOBAL HEALTH AND WELLNESS,
INCREASE OPPORTUNITY FOR WOMEN AND GIRLS, REDUCE CHILDHOOD OBESITY,
CREATE ECONOMIC OPPORTUNITY AND GROWTH, AND HELP COMMUNITIES ADDRESS
THE EFFECTS OF CLIMATE CHANGE. 2 Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes 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?~~~~~~ Yes X 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. 4a (Code: ________ )(Expenses$ 22,636,021. including grantsof$ 34,750. ) (Revenue$ 1,079,538. )
CLINTON GLOBAL INITIATIVE (SEE SCHEDULE O FOR FURTHER DETAILS)
4b (Code: __________ ) (Expenses $ 11,287,293. including grants of $ 5,105. ) (Revenue $ 783,585. ) CLINTON PRESIDENTAL CENTER (SEE SCHEDULE O FOR FURTHER DETAILS)
4c (Code: __________ ) (Expenses $ 8,711,717. including grants of $ 0. ) (Revenue $ 0. ) CLINTON GIUSTRA ENTERPRISE PARTNERSHIP (SEE SCHEDULE O FOR FURTHER
DETAILS)
4d Other program services (Describe in Schedule O.)
(Expenses$ 23,986,884. including grantsof$ 2,732,659. ) (Revenue$ -143,224. ) 4e Total program service expenses | 66,621,915.
Form 990 (201 6) 632002 11-11-16
2 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Expenses $ including grants of $ Revenue $
632002 11-11-16
1
2
3
4
Yes No
Yes No
4a
4b
4c
4d
4e
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part III ����������������������������
Briefly describe the organization's mission:
Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ?
If "Yes," describe these new services on Schedule O.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
If "Yes," describe these changes on Schedule O.
~~~~~~
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.
( ) ( ) ( )
( ) ( ) ( )
( ) ( ) ( )
Other program services (Describe in Schedule O.)
( ) ( )
Total program service expenses |
Form (2016)
2Statement of Program Service AccomplishmentsPart III
990
THE CLINTON FOUNDATION WORKS TO IMPROVE GLOBAL HEALTH AND WELLNESS,
X
X
INCREASE OPPORTUNITY FOR WOMEN AND GIRLS, REDUCE CHILDHOOD OBESITY,
22,636,021. 34,750. 1,079,538.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
CREATE ECONOMIC OPPORTUNITY AND GROWTH, AND HELP COMMUNITIES ADDRESSTHE EFFECTS OF CLIMATE CHANGE.
CLINTON GLOBAL INITIATIVE (SEE SCHEDULE O FOR FURTHER DETAILS)
11,287,293. 5,105. 783,585.CLINTON PRESIDENTAL CENTER (SEE SCHEDULE O FOR FURTHER DETAILS)
8,711,717. 0. 0.CLINTON GIUSTRA ENTERPRISE PARTNERSHIP (SEE SCHEDULE O FOR FURTHERDETAILS)
66,621,915.23,986,884. 2,732,659. -143,224.
X
2 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form 990 FOUNDATION 31-1580204
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, PartII ................................................................................................... 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
ScheduleD, 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 quasi-endowments? 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,
PartVI ..............................................................................................................................................................................
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
Part X, 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, Part X ..................
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, Part X ............ 12a Did the organization obtain separate, independent audited financial statements for the tax year? If Yes, complete
ScheduleD, Parts XI and XII .............................................................................................................................................
b Was the organization included in consolidated, independent audited financial statements for the tax year? If Yes, 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 1 70(b)(1)(A)(ii)? If Yes, complete Schedule E .......................................... 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 Iand 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 11e? 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
1 c and 8a? 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? If Yes,
Page 3
Yes No
1 X
2 X
3 X
4 X
5 X
6 X
7 X
8 X
9 X
10 X
11a X
11b X
11c X
11d X
11e X
11f X
12a X
12b X
13 X
14a X
14b X
15 X
16 X
17 X
18 X
19 X
Form 990 (2016)
632003 11-11-16
3 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632003 11-11-16
Yes No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
1
2
3
4
5
6
7
8
9
10
Section 501(c)(3) organizations.
a
b
c
d
e
f
a
b
11a
11b
11c
11d
11e
11f
12a
12b
13
14a
14b
15
16
17
18
19
a
b
If "Yes," complete Schedule A
Schedule B, Schedule of Contributors
If "Yes," complete Schedule C, Part I
If "Yes," complete Schedule C, Part II
If "Yes," complete Schedule C, Part III
If "Yes," complete Schedule D, Part I
If "Yes," complete Schedule D, Part II
If "Yes," complete
Schedule D, Part III
If "Yes," complete Schedule D, Part IV
If "Yes," complete Schedule D, Part V
If "Yes," complete Schedule D,
Part VI
If "Yes," complete Schedule D, Part VII
If "Yes," complete Schedule D, Part VIII
If "Yes," complete Schedule D, Part IX
If "Yes," complete Schedule D, Part X
If "Yes," complete Schedule D, Part X
If "Yes," complete
Schedule D, Parts XI and XII
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optionalIf "Yes," complete Schedule E
If "Yes," complete Schedule F, Parts I and IV
If "Yes," complete Schedule F, Parts II and IV
If "Yes," complete Schedule F, Parts III and IV
If "Yes," complete Schedule G, Part I
If "Yes," complete Schedule G, Part II
If "Yes,"
complete Schedule G, Part III
Form 990 (2016) Page
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization required to complete ?
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office?
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
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?
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures?
Did the organization maintain collections of works of art, historical treasures, or other similar assets?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
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.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16?
Did the organization report an amount for other liabilities in Part X, line 25?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~
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)?
Did the organization obtain separate, independent audited financial statements for the tax year?
~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization included in consolidated, independent audited financial statements for the tax year?
~~~~~
Is the organization a school described in section 170(b)(1)(A)(ii)?
Did the organization maintain an office, employees, or agents outside of the United States?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
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 11e? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
�����������������������������������������������
Form (2016)
3Part IV Checklist of Required Schedules
990
XX
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
BILL, HILLARY & CHELSEA CLINTON
X
X
XX
FOUNDATION 31-1580204
3 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form 990 FOUNDATION 31-1580204 Page 4
Yes No 20a Did the organization operate one or more hospital facilities? If Yes, complete Schedule H ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20a X
b If Yes to line 20a, did the organization attach a copy of its audited financial statements to this return? ... ... ... ... ... ... ... ... ... ... 20b 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line 1? If Yes, complete Schedule I, Parts IandII .......................................... 21 X 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on
Part IX, column (A), line 2? If Yes, complete Schedule I, Parts IandIII .............................................................................. 22 X 23 Did the organization answer Yes to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees? If Yes, complete
ScheduleJ ........................................................................................................................................................................ 23 X
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
ScheduleK. 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
ScheduleL, Part I ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If Yes,
completeSchedule L, PartII ............................................................................................................................................. 27 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 ..........................................................................................
28 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, Part IV ... ... ... ... ... ... ... ... ... ... ... 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, Part IV ............................................................... 29 Did the organization receive more than $25,000 in non-cash contributions? If Yes, complete Schedule M ........................... 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? If Yes, complete Schedule M ..................................................................................................................... 31 Did the organization liquidate, terminate, or dissolve and cease operations?
If Yes, complete Schedule N, Part I ................................................................................................................................. 31 X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If Yes, complete
ScheduleN, PartII ............................................................................................................................................................ 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3? If Yes, complete Schedule R, Part I ........................................................................ 33 X 34 Was the organization related to any tax-exempt or taxable entity? If Yes, complete Schedule R, Part II, III, or IV, and
PartV,line 1 ..................................................................................................................................................................... 34 X 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 35a X
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 51 2(b)(1 3)? If Yes, complete Schedule R, Part V, line 2 ......................................................... 35b X
36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If Yes, complete Schedule R, Part V, line 2 ........................................................................................................................ 36 X
37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If Yes, complete Schedule R, Part VI ........................ 37 X
38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 b and 19? 38 X
Form 990 (201 6)
24a X 24b
24c 24d
25a X
25b X
26 X
27 X
28a X
28b X
28c X
29 X
30 X
632004 11-11-16
4 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632004 11-11-16
Yes No
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
a
b
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
a
b
c
d
a
b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations.
a
b
c
a
b
Section 501(c)(3) organizations.
Note.
(continued)
If "Yes," complete Schedule H
If "Yes," complete Schedule I, Parts I and II
If "Yes," complete Schedule I, Parts I and III
If "Yes," complete
Schedule J
If "Yes," answer lines 24b through 24d and complete
Schedule K. If "No", go to line 25a
If "Yes," complete Schedule L, Part I
If "Yes," complete
Schedule L, Part I
If "Yes,"
complete Schedule L, Part II
If "Yes," complete Schedule L, Part III
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule M
If "Yes," complete Schedule M
If "Yes," complete Schedule N, Part I
If "Yes," complete
Schedule N, Part II
If "Yes," complete Schedule R, Part I
If "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part VI
Form 990 (2016) Page
Did the organization operate one or more hospital facilities? ~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
Did the organization engage in an excess benefit
transaction with a disqualified person during the year?
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?
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 current or former officer, director, trustee, or key employee? ~~~~~~~~~~~
A family member of a current or former officer, director, trustee, or key employee?
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?
~~
~~~~~~~~~~~~~~~~~~~~~
Did the organization receive more than $25,000 in non-cash contributions?
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions?
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization liquidate, terminate, or dissolve and cease operations?
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3?
Was the organization related to any tax-exempt or taxable entity?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
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)?
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~
Did the organization make any transfers to an exempt non-charitable related organization?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
All Form 990 filers are required to complete Schedule O �������������������������������
Form (2016)
4Part IV Checklist of Required Schedules
990
X
X
XX
XX
X
X
X
X
X
X
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
X
X
X
X
X
X
X
X
X
X
X
4 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 5 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... X
1a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1a 137
b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1b 0
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 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2a 578
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 1 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: J SEE SCHEDULE O 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
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
sponsoring organization have excess business holdings at any time during the year? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 9 Sponsoring organizations maintaining donor advised funds.
a Did the sponsoring organization make any taxable distributions under section 4966? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 10a
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities ~ ~ ~ ~ ~ ~ 10b 11 Section 501(c)(12) organizations. Enter:
a Gross income from members or shareholders ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 11a
b Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 11b 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 .................. 12b 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13a
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
organization is licensed to issue qualified health plans ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13b
c Enter the amount of reserves on hand ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13c 14a Did the organization receive any payments for indoor tanning services during the tax year? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 14a X
b If Yes, has it filed a Form 720 to report these payments? If No, provide an explanation in Schedule O .............................. 14b Form 990 (2016)
632005 11-11-16
1c X
2b X
3a X
3b X
4a X
5a X
5b X 5c
6a X
6b
7a X
7b X
7c X
7e X
7f X
7g 7h
8
9a
5 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632005 11-11-16
Yes No
1
2
3
4
5
6
7
a
b
c
1a
1b
1c
a
b
2a
Note.
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
7g
7h
8
9a
9b
a
b
a
b
a
b
c
a
b
Organizations that may receive deductible contributions under section 170(c).
a
b
c
d
e
f
g
h
7d
8
9
10
11
12
13
14
Sponsoring organizations maintaining donor advised funds.
Sponsoring organizations maintaining donor advised funds.
a
b
Section 501(c)(7) organizations.
a
b
10a
10b
Section 501(c)(12) organizations.
a
b
11a
11b
a
b
Section 4947(a)(1) non-exempt charitable trusts. 12a
12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
Note.
a
b
c
a
b
13a
13b
13c
14a
14b
e-file
If "No," to line 3b, provide an explanation in Schedule O
If "No," provide an explanation in Schedule O
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?
Form (2016)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part V ���������������������������
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners? �������������������������������������������
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 ~~~~~~~~~~
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
If the sum of lines 1a and 2a is greater than 250, you may be required to (see instructions)
~~~~~~~~~~
~~~~~~~~~~~
Did the organization have unrelated business gross income of $1,000 or more during the year?
If "Yes," has it filed a Form 990-T for this year?
~~~~~~~~~~~~~~
~~~~~~~~~~
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)? ~~~~~~~
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
~~~~~~~~~~~~
~~~~~~~~~
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
~~~~~~~~~~~~~~~
����������������������������������������������������
If "Yes," indicate the number of Forms 8282 filed during the year
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
~~~~~~~~~~~~~~~~
~~~~~~~
~~~~~~~~~Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
~
Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year? ~~~~~~~~~~~~~~~~~~~
Did the sponsoring organization make any taxable distributions under section 4966?
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Enter:
Initiation fees and capital contributions included on Part VIII, line 12
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
~~~~~~~~~~~~~~~
~~~~~~
Enter:
Gross income from members or shareholders
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year ������
Is the organization licensed to issue qualified health plans in more than one state?
See the instructions for additional information the organization must report on Schedule O.
~~~~~~~~~~~~~~~~~~~~~
Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans
Enter the amount of reserves on hand
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization receive any payments for indoor tanning services during the tax year?
If "Yes," has it filed a Form 720 to report these payments?
~~~~~~~~~~~~~~~~
����������
5Part V Statements Regarding Other IRS Filings and Tax Compliance
990
J
X
X
XX
X
XX
XX
X
X
XX
1370
578
SEE SCHEDULE O
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
X
X
5 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 6 Part VI Governance, Management, and Disclosure For each 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 Part VI � � � � � � � � � � � � � � � � � � � � � � � � � � � X
Section A. Governing Body and Management
1a Enter the number of voting members of the governing body at the end of the tax year ... ... ... ... ... ... 1a 10
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 O.
b Enter the number of voting members included in line 1 a, above, who are independent ... ... ... ... ... ... 1b 9 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? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 X 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? ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ... ... ... ... ... 4 X 5 Did the organization become aware during the year of a significant diversion of the organization's assets? ... ... ... ... ... ... ... ... ... 5 X 6 Did the organization have members or stockholders? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 X
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? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7a X
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7b X
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8a X
b Each committee with authority to act on behalf of the governing body? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the
9 X
Section B. Policies
10a Did the organization have local chapters, branches, or affiliates? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10a X
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? ... ... ... ... ... ... ... ... ... ... ... ... ... 10b
1 1a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a X
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 ............................................................ 12a X
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ... ... ... ... ... ... 12b X
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If Yes, describe
in Schedule O how this was done ....................................................................................................................................... 1 2 c X
____
13 Did the organization have a written whistleblower policy? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 X 14 Did the organization have a written document retention and destruction policy? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 X 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15a X
b Other officers or key employees of the organization ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15b X
If Yes to line 1 5a or 1 5b, 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? ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16a X
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? � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 16b X
Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed J AK,AL,AR,CA, CT,DC, FL,GA, HI,IL, KS,KY 18 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 Another's website X Upon request Other (explain in Schedule O)
19 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.
20 State the name, address, and telephone number of the person who possesses the organization's books and records: | _____________________
ANDREW KESSEL, CFO - 510-748-0471
1200 PRESIDENT CLINTON AVE, LITTLE ROCK, AR 72201 632006 11-11-16 SEE SCHEDULE O FOR FULL LIST OF STATES Form 990 (2016)
6 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632006 11-11-16
Yes No
1a
1b
1
2
3
4
5
6
7
8
9
a
b
2
3
4
5
6
7a
7b
8a
8b
9
a
b
a
b
Yes No
10
11
a
b
10a
10b
11a
12a
12b
12c
13
14
15a
15b
16a
16b
a
b
12a
b
c
13
14
15
a
b
16a
b
17
18
19
20
For each "Yes" response to lines 2 through 7b below, and for a "No" responseto line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
If "Yes," provide the names and addresses in Schedule O
(This Section B requests information about policies not required by the Internal Revenue Code.)
If "No," go to line 13
If "Yes," describe
in Schedule O how this was done
(explain in Schedule O)
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 O.
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
Form (2016)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part VI ���������������������������
Enter the number of voting members of the governing body at the end of the tax year
Enter the number of voting members included in line 1a, above, who are independent
~~~~~~
~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
Did the organization become aware during the year of a significant diversion of the organization's assets?
Did the organization have members or stockholders?
~~~~~
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The governing body?
Each committee with authority to act on behalf of the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
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? �����������������
Did the organization have local chapters, branches, or affiliates?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~
~~~~~~
Did the organization regularly and consistently monitor and enforce compliance with the policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a written whistleblower policy?
Did the organization have a written document retention and destruction policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
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?
The organization's CEO, Executive Director, or top management official
Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ������������������������������������
List the states with which a copy of this Form 990 is required to be filed
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.
Own website Another's website Upon request Other
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: |
6Part VI Governance, Management, and Disclosure
Section A. Governing Body and Management
Section B. Policies
Section C. Disclosure
990
J
10
9
X
XX
X
XX
XXX
X
X
X
XXXX
X
X
X
X
X
ANDREW KESSEL, CFO - 510-748-04711200 PRESIDENT CLINTON AVE, LITTLE ROCK, AR 72201
X
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
X
AK,AL,AR,CA,CT,DC,FL,GA,HI,IL,KS,KY
SEE SCHEDULE O FOR FULL LIST OF STATES
X
6 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form 990 (2016) FOUNDATION 31-1580204 Page 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors Check if Schedule O contains a response or note to any line in this Part VII � � � � � � � � � � � � � � � � � � � � � � � � � � �
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1a 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 1 099-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.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. _______________
(A) (B) (C) (D) (E) (F) Name and Title Average Position Reportable Reportable Estimated (do not check more than one
hours per box, unless person is both an compensa t i on off i cer anda director/trustee) week
idldiidItttrocerroees
ura
uvn
from (list any the
liiItttttees
ura
no
usn
hours for organization related
iffOrec
(W-2/1 099-MISC) ganizations lKeeyop
meye
below dhiH
tteasn e p m o c s e g
line) l e e y o p m e ________
F r e m r o (1) BRUCE R LINDSEY 45.00
DIRECTOR 5.00 X 361,308. 0. 42,384.
(2) CHELSEA V. CLINTON 25.00
DIRECTOR 10.00 X 0. 0. 0.
(3) CHERYL MILLS 5.00
DIRECTOR X 0. 0. 0.
(4) CHERYL SABAN 5.00
DIRECTOR X 0. 0. 0.
(5) ERIC GOOSBY 5.00
DIRECTOR X 0. 0. 0.
(6) FRANK GUISTRA 5.00
DIRECTOR X 0. 0. 0.
(7) HADEEL IBRAHIM 5.00
DIRECTOR X 0. 0. 0.
(8) LISA JACKSON 5.00
DIRECTOR X 0. 0. 0.
(9) ROLANDO GONZALEZ BUNSTER 5.00
DIRECTOR X 0. 0. 0.
(10) WILLIAM JEFFERSON CLINTON 20.00
DIRECTOR 5.00 X 0. 0. 0.
(11) ANDREW KESSEL 50.00
CFO __________
X 190,159. 0. 38,074.
(12) DONNA SHALALA 50.00
PRESIDENT AND CEO ________
X 0. 0. 0.
(13) KEVIN THURM 50.00
COO, EVP __________
X 394,137. 0. 46,155.
(14) RICARDO CASTRO 50.00
GENERAL COU N SEL X 268,218. 0. 39,783.
(15) SCOTT CURRAN 50.00
ASSISTA N T SECRETARY X 172,226. 0. 26,822.
(16) STEPHA N IE S. STREETT 50.00
EXECUTIVE DIRECTOR, SECRETARY X 195,197. 0. 39,557.
(17) DANIELLE STILZ 50.00
CDO X 191,098. 0. 26,712. 632007 11-11-16 Form 990 (2016)
7 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
compensation amount of from related other
organizations compensation (W-2/1 099-MISC) from the
organization and related
organizations
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Key
empl
oyee
Hig
hest
com
pens
ated
empl
oyee
Form
er
(do not check more than onebox, unless person is both anofficer and a director/trustee)
632007 11-11-16
current
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a
current
current
former
former directors or trustees
(A) (B) (C) (D) (E) (F)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part VII ���������������������������
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 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 key employees, if any. See instructions for definition of "key employee."¥ List the organization's five 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 officers, key employees, and highest compensated employees who received more than $100,000 ofreportable compensation from the organization and any related organizations.
¥ List all of the organization's 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.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
PositionName and Title Average hours per
week (list any
hours forrelated
organizationsbelowline)
Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
Form (2016)
7Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
990
(1) BRUCE R LINDSEYDIRECTOR(2) CHELSEA V. CLINTON
(3) CHERYL MILLS
(4) CHERYL SABAN
(5) ERIC GOOSBY
(6) FRANK GUISTRA
(7) HADEEL IBRAHIM
(8) LISA JACKSON
(9) ROLANDO GONZALEZ BUNSTER
(10) WILLIAM JEFFERSON CLINTON
(11) ANDREW KESSEL
(12) DONNA SHALALA
(13) KEVIN THURM
(14) RICARDO CASTRO
(15) SCOTT CURRAN
(16) STEPHANIE S. STREETT
(17) DANIELLE STILZ
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
DIRECTOR
CFO
PRESIDENT AND CEO
COO, EVP
GENERAL COUNSEL
ASSISTANT SECRETARY
EXECUTIVE DIRECTOR, SECRETARY
CDO
45.00
25.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
20.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
361,308.
0.
0.
0.
0.
0.
0.
0.
0.
0.
190,159.
0.
394,137.
268,218.
172,226.
195,197.
191,098.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
42,384.
0.
0.
0.
0.
0.
0.
0.
0.
0.
38,074.
0.
46,155.
39,783.
26,822.
39,557.
26,712.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
5.00
10.00
5.00
7 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(A) Name and title
(18) MAURA PALLY
SVP PROGRAMS
(19) ROBERT S. HARRISON
CEO, CGI
(20) AMITABH DESAI
FOREIGN POLICY DIRECTOR
(21) CAROLINA BOTERO
CFO, CGEP
(22) DAVID WATT
DIRECTOR OF SPONSORSHIP, CGI
(23) DYMPHNA VAN DER LANS
CEO, CCI
(24) MARK GUNTON
CEO, CGEP
(B) (C) Average Position
(do not check more than one hours per box, unless person is both an
week officer and a director/trustee)
(list any hours for related
ganizations below line)
50.00
X
50.00
X
50.00
X
50.00
X
50.00 i d l d i i d I t t t r o c e r r o e e s u r a u v n
l i i I t t t t t e e s u r a n o u s n X
50.00 i f f O r e c
X l K e e y o p m e y e
50.00 d h i H t t e a s n e p m o c s e gX l e e y o p m e
F r e m r o
(D) Reportable
compensation from the
organization (W-2/1 099-MISC)
299,080.
240,704.
207,823.
208,747.
267,249.
244,780.
287,758.
31-1580204 Page 8
(continued) ______________
(E) (F) Reportable Estimated
compensation amount of from related other
organizations compensation (W-2/1 099-MISC) from the
organization and related
organizations
0 . 26,217.
0 . 41,660.
0 . 39,487.
0. 37,185.
0. 43,660.
0. 37,076.
0. 42,105.
BILL, HILLARY & CHELSEA CLINTON
Form 990 FOUNDATION
1b Sub-total ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | 3,528,484. 0.
c Total from continuation sheets to Part VII, Section A ~~~~~~~~~~ | 0. 0.
d Total(addlines 1band 1c) ������������������������ | 3,528,484. 0. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from theorganizat ion |
_____________________________________ 526,877.
_____________________________________ 0.
526,877.
66
Yes No 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
line 1 a? If Yes, complete Schedule J for such individual ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 X 4 For any individual listed on line 1 a, 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 ~~~~~~~~~~~~~ 4 X 5 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 Yes, complete ScheduleJ for such person ������������������������ 5 - 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) (B) (C) Name and business address Description of services Compensation
ROUNDBOXX GROUP, INC
PO BOX 575, HERMOSA BEACH, CA 90254 C ONFERENCE PRODUCTION SERVICE S 897,180.
PRICEWATERHOUSECOOPERS LLC
PO BOX 952282, DALLAS, TX 75395 AUDIT AND TAX SERVICES 757,300.
PHASE2 TECHNOLOGY, LLC
1330 BRADDOCK PLACE, ALEXANDRIA, VA 22314 W EBSITE DEVELOPMENT 362,000.
THE MULLION GROUP PTY LTD, 453 LEDGERS
CREEK ROAD, MULLION, MULLION, AUSTRALIA T ECHNICAL ADVISORY SERVICES 324,438.
OSA INTERNATIONAL INC.
537 N EDGEWOOD AVE., WOOD DALE, IL 60191 P RODUCTION SERVICES 252,282. 2 Total number of independent contractors (including but not limited to those listed above) who received more than
$1 00 000 of compensat ion from theorganization | 15
Form 990 (201 6) 632008 11-11-16
8 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Form
er
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Hig
hest
com
pens
ated
empl
oyee
Key
empl
oyee
(do not check more than onebox, unless person is both anofficer and a director/trustee)
632008 11-11-16
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(B) (C)(A) (D) (E) (F)
1b
c
d
Sub-total
Total from continuation sheets to Part VII, Section A
Total (add lines 1b and 1c)
2
Yes No
3
4
5
former
3
4
5
Section B. Independent Contractors
1
(A) (B) (C)
2
(continued)
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such person
Page Form 990 (2016)
PositionAverage hours per
week(list any
hours forrelated
organizationsbelowline)
Name and title Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
~~~~~~~~~~ |
������������������������ |
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 officer, director, or trustee, key employee, or highest compensated employee on
line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? ������������������������
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.
Name and business address Description of services Compensation
Total number of independent contractors (including but not limited to those listed above) who received more than
$100,000 of compensation from the organization |
Form (2016)
8Part VII
990
(18) MAURA PALLYSVP PROGRAMS
50.00X 299,080. 0. 26,217.
(19) ROBERT S. HARRISONCEO, CGI
50.00X 240,704. 0. 41,660.
(20) AMITABH DESAIFOREIGN POLICY DIRECTOR
50.00X 207,823. 0. 39,487.
(21) CAROLINA BOTEROCFO, CGEP
50.00X 208,747. 0. 37,185.
(22) DAVID WATTDIRECTOR OF SPONSORSHIP, CGI
50.00X 267,249. 0. 43,660.
(23) DYMPHNA VAN DER LANSCEO, CCI
50.00X 244,780. 0. 37,076.
(24) MARK GUNTONCEO, CGEP
50.00X 287,758. 0. 42,105.
3,528,484. 0. 526,877.0. 0. 0.
PO BOX 575, HERMOSA BEACH, CA 90254
PO BOX 952282, DALLAS, TX 75395
1330 BRADDOCK PLACE, ALEXANDRIA, VA 22314
CREEK ROAD, MULLION, MULLION, AUSTRALIA
537 N EDGEWOOD AVE., WOOD DALE, IL 60191
66
15
3,528,484. 0. 526,877.
X
FOUNDATION
X
X
31-1580204
ROUNDBOXX GROUP, INC
BILL, HILLARY & CHELSEA CLINTON
PRICEWATERHOUSECOOPERS LLC
PHASE2 TECHNOLOGY, LLC
THE MULLION GROUP PTY LTD, 453 LEDGERS
OSA INTERNATIONAL INC.
CONFERENCE PRODUCTION SERVICES
AUDIT AND TAX SERVICES
WEBSITE DEVELOPMENT
TECHNICAL ADVISORY SERVICES
PRODUCTION SERVICES
897,180.
757,300.
362,000.
324,438.
252,282.
8 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 9 Part VIII Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII ........................................................................... (A) (B)
Total revenue Related or Unrelated exempt function business
revenue revenue
GCGfbiiit t t t o n s s r r a n n o u s
, ,
O S h A d i l i t t o s n n m r u e m a r a
1 a Federated campaigns ~ ~ ~ ~ ~ ~ 1a 38,905.
b Membership dues ~ ~ ~ ~ ~ ~ ~ ~ 1 b 118,875.
c Fundraising events ~ ~ ~ ~ ~ ~ ~ ~ 1 c 12,330,627.
d Related organizations ~ ~ ~ ~ ~ ~ 1d 3,786,590.
e Government grants (contributions) 1e 4,719,576.
f All other contributions, gif t s, grants, and
similar amounts not included above ~ ~ 1f 41,917,758.
g Noncash contributions included in lines 1a-1f: $ 550 ,543.
h Total. Add lines 1a-1f ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... |
SP i v r e c e m r o g
r a
R e
v u e e n
2 a PRESIDENTIAL CENTER 900099
b CLINTON GLOBAL INITIAT 900099
c OTHER PROGRAM SERVICE 900099
d CLINTON DEV.INITIATIVE 900099
e
f All other program service revenue ~ ~ ~ ~ ~ .___________
- g Total. Add lines 2a-2f ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... | 3 Investment income (including dividends, interest, and
other similar amounts) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | 4 Income from investment of tax-exempt bond proceeds | 5 Royalties ..................................................................... |
OhRtenurevee
6 a Gross rents ~~~~~~~ 983,853 .
b Less: rental expenses ~~~ 957,262 .
c Rental income or (loss) ~~ 26,591 .
d Net rental income or (loss) .......................................... | 7 a Gross amount from sales of (i) Securities (i i ) Other
assetsotherthan inventory 1,718,309. 2,188,648.
b Less: cost or other basis andsalesexpenses ~~~ 1,333,427. 2,639,312.
c Gainor(loss) ~~~~~~~ 384,882. -450,664.
d Net gain or (loss) ......................................................... | 8 a Gross income from fundraising events (not
including$ 12,330,627. of contributions reported on line 1c). See Part IV, line 18 ~~~~~~~~~~~~~ a 68,368.
b Less: direct expenses~~~~~~~~~~ b 936,530.
c Net income or (loss) from fundraising events ... ... ... ... ... | 9 a Gross income from gaming activities. See
Part IV, line 19 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a __________
b Less: direct expenses ~~~~~~~~~ b _____________
c Net income or (loss) from gaming activities .................. | 10 a Gross sales of inventory, less returns
andallowances ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ a 2,149,834.
b Less: cost of goods sold ~~~~~~~~ b 747,526.
62,912,331. _______________
1,625,055. 735,469. 889,586. 1,079,538. 1,079,538.
204,538. 204,538. 3,301. 3,301.
2,912,432. _______________
4,807,873. 141,871. 4,666,002.
26,591. _______________ 26,591.
-65,782. -450,664. 89,704. 295,178.
-868,162. -868,162.
Miscellaneous Revenue 11 a OTHER REVENUE
b LOSS ON CDI FARMING
c
d All other revenue ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ e Total. Add lines 11 a-11 d ~ ~ ~ ~ ~ ~ ~ ~ ~
900099 900099
~ ~ ~ |
1,402,308.
104,122. -455,185.
-351,063.
498,780. 903,528.
104,122. -455,185.
- 12 Totalrevenue. Seeinstructions. ... ... ... ... ... ... ... ... ... ... ... ... ... | I 70,776,528. 1,719,899. 2,024,689. 4,119,609. 632009 11-11-16 Form 990 (2016)
9 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Noncash contributions included in lines 1a-1f: $
632009 11-11-16
Total revenue.
(A) (B) (C) (D)
1 a
b
c
d
e
f
g
h
1
1
1
1
1
1
a
b
c
d
e
f
Co
ntr
ibu
tio
ns,
Gif
ts,
Gra
nts
an
d O
the
r S
imila
r A
mo
un
ts
Total.
Business Code
a
b
c
d
e
f
g
2
Pro
gra
m S
erv
ice
Re
ven
ue
Total.
3
4
5
6 a
b
c
d
a
b
c
d
7
a
b
c
8
a
b
9 a
b
c
a
b
10 a
b
c
a
b
Business Code
11 a
b
c
d
e Total.
Oth
er
Re
ven
ue
12
Revenue excludedfrom tax under
sections512 - 514
All other contributions, gifts, grants, and
similar amounts not included above
See instructions.
Form (2016)
Page Form 990 (2016)
Check if Schedule O contains a response or note to any line in this Part VIII �������������������������
Total revenue Related orexempt function
revenue
Unrelatedbusinessrevenue
Federated campaigns
Membership dues
~~~~~~
~~~~~~~~
Fundraising events
Related organizations
~~~~~~~~
~~~~~~
Government grants (contributions)
~~
Add lines 1a-1f ����������������� |
All other program service revenue ~~~~~
Add lines 2a-2f ����������������� |
Investment income (including dividends, interest, and
other similar amounts)
Income from investment of tax-exempt bond proceeds
~~~~~~~~~~~~~~~~~ |
|
Royalties ����������������������� |
(i) Real (ii) Personal
Gross rents
Less: rental expenses
Rental income or (loss)
Net rental income or (loss)
~~~~~~~
~~~
~~
�������������� |
Gross amount from sales of
assets other than inventory
(i) Securities (ii) Other
Less: cost or other basis
and sales expenses
Gain or (loss)
~~~
~~~~~~~
Net gain or (loss) ������������������� |
Gross income from fundraising events (not
including $ of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~
Less: direct expenses ~~~~~~~~~~
Net income or (loss) from fundraising events ����� |
Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~
Less: direct expenses
Net income or (loss) from gaming activities
~~~~~~~~~
������ |
Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~
Less: cost of goods sold
Net income or (loss) from sales of inventory
~~~~~~~~
������ |
Miscellaneous Revenue
All other revenue ~~~~~~~~~~~~~
Add lines 11a-11d ~~~~~~~~~~~~~~~ |
|�������������
9Part VIII Statement of Revenue
990
38,905.118,875.
12,330,627.3,786,590.4,719,576.
1,625,055.
41,917,758.
62,912,331.550,543.
OTHER REVENUE 900099
2,912,432.
1,079,538.204,538.3,301.
104,122.LOSS ON CDI FARMING 900099
-455,185.
70,776,528. 1,719,899. 2,024,689. 4,119,609.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
PRESIDENTIAL CENTER 900099 889,586. 735,469.CLINTON GLOBAL INITIAT 900099 1,079,538.OTHER PROGRAM SERVICE 900099
4,807,873.
141,871. 4,666,002.
983,853.957,262.26,591.
26,591. 26,591.
204,538.CLINTON DEV.INITIATIVE 900099
1,718,309.
1,333,427.384,882.
2,188,648.
2,639,312.-450,664.
-65,782. -450,664. 89,704. 295,178.
68,368.936,530.
-868,162. -868,162.
2,149,834.747,526.
1,402,308. 498,780. 903,528.
12,330,627.
104,122.-455,185.
-351,063.
3,301.
9 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
2,641,123. 517,119. 1,906,194.
61,537. 61,537. 26,069,645. 20,221,522. 4,440,932.
1,415,415. 1,089,486. 247,608. 4,766,757. 3,588,129. 953,365. 2,406,012. 1,807,509. 469,902.
501,491. 185,278. 315,809. 891,612. 146,581. 745,031.
147,564. 3,168,685. 3,168,685.
6,326,773. 5,242,978. 928,505. 392,460. 316,391. 26,399.
1,216,545. 518,422. 636,333. 1,548,457. 633,440. 899,316.
217,810.
1,407,191.
78,321. 225,263. 128,601.
404.
147,564.
155,290. 49,670. 61,790. 15,701.
4,811,368. 3,544,153. 953,063. 314,152. 3,917,419. 3,626,793. 288,692. 1,934.
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 10 Part IX Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
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 1 1g amount exceeds 10% of line 25,
column (A) amount, list line 1 1g expenses on Sch O.) 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 O.)
a DIRECT PROGRAM
b LOSS ON PROGRAM INVESTM
c EXHIBITS AND FIXTURES
d STAFF TRAINING AND DEVE
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)
632010 11-11-16
Total expenses Program service and
2,513,481. 2,513,481.
259,033. 259,033.
9,027,648. 8,960,978. 64,720. 1,950.
6,071,818. 5,285,700. 416,128. 369,990. 562,424. 156,900. 405,524.
4,965,952. 1,813,284.
411,885. 332,452.
1,174,458. 87,415,298.
4,965,952. 1,813,284.
411,885. 70,913.
745,988. 66,621,915.
261,539. 255,382.
17,444,664. 173,088.
3,348,719.
Form 990 (2016) 10
2016.05000 BILL, HILLARY & CHELSEA C 02278101 13491114 147227 0227810-0227935.0990
Check here if following SOP 98-2 (ASC 958-720)
632010 11-11-16
Total functional expenses.
Joint costs.
(A) (B) (C) (D)
1
2
3
4
5
6
7
8
9
10
11
a
b
c
d
e
f
g
12
13
14
15
16
17
18
19
20
21
22
23
24
a
b
c
d
e
25
26
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Professional fundraising services. See Part IV, line 17
(If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.)
Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line24e amount exceeds 10% of line 25, column (A)amount, list line 24e expenses on Schedule O.)
Add lines 1 through 24e
Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part IX ��������������������������
Total expenses Program serviceexpenses
Management andgeneral expenses
Fundraisingexpenses
~
Grants and other assistance to domestic
individuals. See Part IV, line 22 ~~~~~~~
Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16 ~~~
Benefits paid to or for members ~~~~~~~
Compensation of current officers, directors,
trustees, and key employees ~~~~~~~~
~~~
Other salaries and wages ~~~~~~~~~~
Other employee benefits ~~~~~~~~~~
Payroll taxes ~~~~~~~~~~~~~~~~
Fees for services (non-employees):
Management
Legal
Accounting
Lobbying
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Investment management fees
Other.
~~~~~~~~
Advertising and promotion
Office expenses
Information technology
Royalties
~~~~~~~~~
~~~~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Occupancy ~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~Travel
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings ~~
Interest
Payments to affiliates
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Depreciation, depletion, and amortization
Insurance
~~
~~~~~~~~~~~~~~~~~
All other expenses
|
Form (2016)
Do not include amounts reported on lines 6b,7b, 8b, 9b, and 10b of Part VIII.
10Part IX Statement of Functional Expenses
990
2,513,481.
259,033.
2,641,123.
61,537.26,069,645.
1,415,415.4,766,757.2,406,012.
501,491.891,612.
147,564.
6,326,773.392,460.
1,216,545.1,548,457.
4,811,368.3,917,419.
9,027,648.
6,071,818.562,424.
4,965,952.1,813,284.411,885.332,452.
1,174,458.87,415,298.
3,168,685.
2,513,481.
259,033.
517,119. 1,906,194. 217,810.
61,537. 20,221,522. 4,440,932. 1,407,191.
1,089,486. 247,608. 78,321.3,588,129. 953,365. 225,263.1,807,509. 469,902. 128,601.
185,278. 315,809. 404.146,581. 745,031.
147,564.
3,168,685.
5,242,978. 928,505. 155,290.316,391. 26,399. 49,670.518,422. 636,333. 61,790.633,440. 899,316. 15,701.
3,544,153. 953,063. 314,152.3,626,793. 288,692. 1,934.
8,960,978. 64,720. 1,950.
5,285,700. 416,128. 369,990.156,900. 405,524.
4,965,952. 1,813,284. 411,885. 70,913. 261,539. 745,988. 255,382. 173,088.
66,621,915. 17,444,664. 3,348,719.
DIRECT PROGRAMLOSS ON PROGRAM INVESTMEXHIBITS AND FIXTURESSTAFF TRAINING AND DEVE
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
10 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
7 I 889,273. 2,173,224. 8
651,982. 9
104,357,939. 10c 36,815,371. 11 82,351,196. 12 2,733,171. 13
14
67,072. 15 359,923,364. 16
7,012,261. 17 18
6,302,182. 19 20
21
22
23
24
25
13,314,443. 26
753,190. 899,814.
96,843,172. 42,683,182.
105,218,916. 3,467,843.
335,481,447. 7,466,397.
1,279,854.
8,746,251.
BILL, HILLARY & CHELSEA CLINTON
Form 990 FOUNDATION
Check if Schedule O contains a response or note to any line in this Part X
Atsses
1 Cash - non-interest-bearing ........................................................................... 2 Savings and temporary cash investments ...................................................... 3 Pledges and grants receivable, net ............................................................... 4 Accounts receivable, net .............................................................................. 5 Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ....................................................................................
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501 (c)(9) voluntary employees' beneficiary organizations (see instr). Complete Part II of Sch L ......
7 Notes and loans receivable, net ..................................................................... 8 Inventories for sale or use ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Prepaid expenses and deferred charges ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D ... ... ... 10a 148,417,135.
b Less: accumulated depreciation ... ... ... ... ... ... 10b 51,573,963. 11 Investments - publicly traded securities ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Investments - other securities. See Part IV, line 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Investments - program-related. See Part IV, line 11 ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Intangible assets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Other assets. See Part IV, line 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
iLlibiits a e
17 Accoun t s payable and accrued expenses ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Gra n ts payable ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 19 Deferred revenue ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 Tax-exempt bond liabili t ies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21 Escrow or cus t odial account liability. Comple t e Par t IV of Schedule D
... ... ... ... 22 Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
23 Secured mortgages and notes payable to unrelated third parties ... ... ... ... ... ... 24 Unsecured notes and loans payable to unrelated third parties ... ... ... ... ... ... ... ... 25 Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
(A) Beginning of year
28,329,841. 18,737,426. 81,981,740. 1,724,402.
31-1580204 Page 11
� � � � � � � � � � � � (B)
End of year
1 13,625,081.
2 17,647,133.
3 52,072,670.
4 i _i 1,381,173.
NlFABdt teossnuesrsaeanc
Organizations that follow SFAS 117 (ASC 958), check here | X and
complete lines 27 through 29, and lines 33 and 34. 27 Unrestricted net assets ................................................................................. 28 Temporarily restricted net assets .................................................................. 29 Permanently restricted net assets ...............................................................
Organizations that do not follow SFAS 117 (ASC 958), check here | and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ............................................. 31 Paid-in or capital surplus, or land, building, or equipment fund ........................ 32 Retained earnings, endowment, accumulated income, or other funds ... ... ... ... 33 Total net assets or fund balances ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
147,675,145. 27 15,319,058. 28
183,614,718. 29
30
31
32
346,608,921. 33 359,923,364. 34
128,180,966. 16,479,445.
182,074,785.
326,735,196. 335,481,447.
Form 990 (201 6)
632011 11-11-16
11 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632011 11-11-16
(A) (B)
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24
25
26
a
b
10a
10b
Asse
ts
Total assets.
Lia
bili
tie
s
Total liabilities.
Organizations that follow SFAS 117 (ASC 958), check here and
complete lines 27 through 29, and lines 33 and 34.
27
28
29
Organizations that do not follow SFAS 117 (ASC 958), check here
and complete lines 30 through 34.
30
31
32
33
34
Ne
t A
sse
ts o
r F
un
d B
ala
nc
es
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part X �����������������������������
Beginning of year End of year
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
~~~
~~~~~~
Investments - publicly traded securities
Investments - other securities. See Part IV, line 11
Investments - program-related. See Part IV, line 11
Intangible assets
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~
Add lines 1 through 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 of Schedule D
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~
Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~
Secured mortgages and notes payable to unrelated third parties ~~~~~~
Unsecured notes and loans payable to unrelated third parties ~~~~~~~~
Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X of
Schedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 17 through 25 ������������������
|
Unrestricted net assets
Temporarily restricted net assets
Permanently restricted net assets
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
|
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund
Retained earnings, endowment, accumulated income, or other funds
~~~~~~~~~~~~~~~
~~~~~~~~
~~~~
Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~
Total liabilities and net assets/fund balances ����������������
Form (2016)
11Balance SheetPart X
990
28,329,841. 13,625,081.
1,724,402. 1,381,173.81,981,740. 52,072,670.
2,733,171. 3,467,843.
889,273.2,173,224. 753,190.651,982. 899,814.
36,815,371. 42,683,182.
148,417,135.51,573,963. 104,357,939. 96,843,172.
67,072. 359,923,364. 335,481,447.
18,737,426. 17,647,133.
7,012,261. 7,466,397.
6,302,182. 1,279,854.
13,314,443. 8,746,251.
X
147,675,145. 128,180,966.15,319,058. 16,479,445.183,614,718. 182,074,785.
346,608,921. 326,735,196.359,923,364. 335,481,447.
31-1580204FOUNDATIONBILL, HILLARY & CHELSEA CLINTON
82,351,196. 105,218,916.
11 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form990(2016) FOUNDATION 31-1580204 Page 12 Part XI I Reconciliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- X
1 Total revenue (must equal Part VIII, column (A), line 12) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 70,776,528. 2 Total expenses (must equal Part IX, column (A), line 25) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 87,415,298. 3 Revenue less expenses. Subtract line 2 from line 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -16,638,770. 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ~ ~ ~ ~ ~ ~ ~ 346,608,921. 5 Net unrealized gains (losses) on investments ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4,599,896. 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 O) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -7,834,851. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B)) --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 326,735,196.
t X I I Financial Statements and Reporting Check if Schedule O contains a response or note to any line in this Part XII --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- X
Yes No 1 Accounting method used to prepare the Form 990: Cash X Accrual 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2a X
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:
Separate basis Consolidated basis Both consolidated and separate basis
b Were the organization's financial statements audited by an independent accountant? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2b X
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:
Separate basis X Consolidated basis 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2c X
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-1 33? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3a X
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 any steps taken to undergo such audits --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- 3b I
Form 990 (2016)
632012 11-11-16
12 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632012 11-11-16
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Yes No
1
2
3
a
b
c
2a
2b
2c
a
b
3a
3b
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part XI ���������������������������
Total revenue (must equal Part VIII, column (A), line 12)
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other changes in net assets or fund balances (explain in Schedule O)
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
~~~~~~~~~~~~~~~~~~~
�����������������������������������������������
Check if Schedule O contains a response or note to any line in this Part XII ���������������������������
Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
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:
Separate basis Consolidated basis Both consolidated and separate basis
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:
Separate basis Consolidated basis Both consolidated and separate basis
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.
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 any steps taken to undergo such audits ����������������
Form (2016)
12Part XI Reconciliation of Net Assets
Part XII Financial Statements and Reporting
990
X
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
X
70,776,528.87,415,298.-16,638,770.346,608,921.
-7,834,851.
326,735,196.
X
4,599,896.
X
X
X
X
X
12 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
SCHEDULE A 1
Public Charity Status and Public Support (Form 990 or 990-EZ) Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust. Department of the Treasury | Attach to Form 990 or Form 990-EZ. Internal Revenue Service | Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/f
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
OMB No. 1545-0047
2016 Open to Public
Inspection
Employer identification number 31-1580204
must this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.) 1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).) 3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). 4 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name,
city, and state: 5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(b)(1)(A)(iv). (Complete Part II.) 6 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7 X An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
section 170(b)(1)(A)(vi). (Complete Part II.) 8 A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college
or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or
university: 10 An 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 III.) 11 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 12 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in
lines 1 2a through 1 2d that describes the type of supporting organization and complete lines 1 2e, 1 2f, and 12g.
a 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 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 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 Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
e 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 organizations ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. 632021 09-21-16 Schedule A (Form 990 or 990-EZ) 2016 13
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(iv) Is the organization listedin your governing document?
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632021 09-21-16
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at
(i) (iii) (v) (vi)(ii) Name of supported
organization
Type of organization (described on lines 1-10 above (see instructions))
Amount of monetary
support (see instructions)
Amount of other
support (see instructions)
EIN
(Form 990 or 990-EZ)Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.| Attach to Form 990 or Form 990-EZ.
|
Open to PublicInspection
Name of the organization Employer identification number
1
2
3
4
5
6
7
8
9
10
11
12
section 170(b)(1)(A)(i).
section 170(b)(1)(A)(ii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iv).
section 170(b)(1)(A)(v).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(ix)
section 509(a)(2).
section 509(a)(4).
section 509(a)(1) section 509(a)(2) section 509(a)(3).
a
b
c
d
e
f
g
Type I.
You must complete Part IV, Sections A and B.
Type II.
You must complete Part IV, Sections A and C.
Type III functionally integrated.
You must complete Part IV, Sections A, D, and E.
Type III non-functionally integrated.
You must complete Part IV, Sections A and D, and Part V.
Yes No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2016
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
A church, convention of churches, or association of churches described in
A school described in (Attach Schedule E (Form 990 or 990-EZ).)
A hospital or a cooperative hospital service organization described in
A medical research organization operated in conjunction with a hospital described in Enter the hospital's name,
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
(Complete Part II.)
A federal, state, or local government or governmental unit described in
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
(Complete Part II.)
A community trust described in (Complete Part II.)
An agricultural research organization described in operated in conjunction with a land-grant college
or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or
university:
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 (Complete Part III.)
An organization organized and operated exclusively to test for public safety. See
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 or . See Check the box in
lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
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.
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).
A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions).
A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions).
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.
Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Provide the following information about the supported organization(s).
LHA
www.irs.gov/form990.
SCHEDULE A
Part I Reason for Public Charity Status
Public Charity Status and Public Support2016
X
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
13 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 2 Part I I Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support __________ __________ __________ __________ __________ ___________
Calendar year (or fiscal year beginning in) | (a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) 2016 (f) Total 1 Gifts, grants, contributions, and
membership fees received. (Do not includeany unusualgrants. ) ~ ~ 49,937,264. 142,885,956. 172,579,474. 108,915,463. 62,901,979. 537,220,136.
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 ~ ~ ~ 49,937,264. 142,885,956. 172,579,474. 108,915,463. 62,901,979. 537,220,136. 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) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ._____________ _____________ _____________ _____________ _____________ 24,968,737. 6 Public support. Subtract line 5 from line 4 . 512,251,399.
Calendar year (or fiscal year beginning in) | (a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) 2016 (f) Total 7 Amountsfrom line 4 ~ ~ ~ ~ ~ ~ ~ 49,937,264. 142,885,956. 172,579,474. 108,915,463. 62,901,979. 537,220,136. 8 Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and incomefromsimilarsources ~ 60,308. 159,457. 388,177. 4,074,096. 5,791,726. 10,473,764. 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 PartVI.) ~ ~ ~ ~ 2,464,256. 4,419,621. 5,107,819. 2,007,224. 216,085. 14,215,005. 11 Total support. Add lines 7 through 10 _______________ _______________ ______________ ______________ 561,908,905. 12 Gross receipts from related activities, etc. (see instructions) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 12 I 10,363,071. 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 14 Public support percentage for 2016 (line 6, column (f ) divided by line 11, column (f)) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 14 91.16 % 15 Public support percentage from 2015 Schedule A, Part II, line 14 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 15 90.40 % 16a 33 1/3% support test - 2016. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
stop here. The organization qualifies as a publicly supported organization ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | X
b 33 1/3% support test - 2015. If the organization did not check a box on line 13 or 1 6a, 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 - 2016. If the organization did not check a box on line 13, 1 6a, or 1 6b, 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 - 2015. If the organization did not check a box on line 13, 1 6a, 1 6b, or 1 7a, 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, 1 6a, 1 6b, 1 7a, or 1 7b, check this box and see instructions ... ... ... |
Schedule A (Form 990 or 990-EZ) 2016
632022 09-21-16
14 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Subtract line 5 from line 4.
632022 09-21-16
Calendar year (or fiscal year beginning in)
Calendar year (or fiscal year beginning in) |
2
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
Total.
6 Public support.
(a) (b) (c) (d) (e) (f)
7
8
9
10
11
12
13
Total support.
12
First five years.
stop here
14
15
14
15
16
17
18
a
b
a
b
33 1/3% support test - 2016.
stop here.
33 1/3% support test - 2015.
stop here.
10% -facts-and-circumstances test - 2016.
stop here.
10% -facts-and-circumstances test - 2015.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2016
|
Add lines 7 through 10
Schedule A (Form 990 or 990-EZ) 2016 Page
(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 III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
2012 2013 2014 2015 2016 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
Add lines 1 through 3 ~~~
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) ~~~~~~~~~~~~
2012 2013 2014 2015 2016 Total
Amounts from line 4 ~~~~~~~
Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
Net income from unrelated business
activities, whether or not the
business is regularly carried on ~
Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part VI.) ~~~~
Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~
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 ��������������������������������������������� |
~~~~~~~~~~~~Public support percentage for 2016 (line 6, column (f) divided by line 11, column (f))
Public support percentage from 2015 Schedule A, Part II, line 14
%
%~~~~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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 The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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 Explain in Part VI how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
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 Explain in Part VI how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ��� |
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
49,937,264.
49,937,264.
142,885,956.
142,885,956.
172,579,474. 108,915,463. 62,901,979. 537,220,136.
172,579,474. 108,915,463. 62,901,979. 537,220,136.
24,968,737.512,251,399.
49,937,264. 142,885,956. 172,579,474. 108,915,463. 62,901,979. 537,220,136.
60,308. 159,457. 388,177. 4,074,096. 5,791,726. 10,473,764.
2,464,256. 4,419,621. 5,107,819. 2,007,224. 216,085. 14,215,005.561,908,905.10,363,071.
91.1690.40
X
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
14 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 3
Part I I I Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 10 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 per-
formed, 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 bus-
iness under section 513 ~ ~ ~ ~ ~
4 Tax revenues levied for the organ-
ization'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 ~ ~ ~ ~ ~ ~ ~
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.) _______________ _______________ _______________ _______________ _______________
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,
of Public 15 Public support percentage for 2016 (line 8, column (f ) divided by line 13, column (f)) ~ ~ ~ ~ ~ ~ ~ ~ ~ 16 Public support percentage from 2015 Schedule A, Part III, line 15 � � � � � � � � � � � � � � � � � � % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2016 (line 10c, column (f) divided by line 13, column (f)) ~ ~ ~ ~ ~ ~ ~ ~ 17 % 18 Investment income percentage from 2015 Schedule A, Part III, line 17 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 18 % 19a 33 1/3% support tests - 2016. 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 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ |
b 33 1/3% support tests - 2015. If the organization did not check a box on line 14 or line 1 9a, 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 ~ ~ ~ ~ | 20 Private foundation. If the organization did not check a box on line 14, 1 9a, or 1 9b, check this box and see instructions � � � � � � � � | 632023 09-21-16 Schedule A (Form 990 or 990-EZ) 2016
15 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(Subtract line 7c from line 6.)
Amounts included on lines 2 and 3 received
from other than disqualified persons that
exceed the greater of $5,000 or 1% of the
amount on line 13 for the year
(Add lines 9, 10c, 11, and 12.)
632023 09-21-16
Calendar year (or fiscal year beginning in) |
Calendar year (or fiscal year beginning in) |
Total support.
3
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
6
7
Total.
a
b
c
8 Public support.
(a) (b) (c) (d) (e) (f)
9
10a
b
c11
12
13
14 First five years.
stop here
15
16
15
16
17
18
19
20
2016
2015
17
18
a
b
33 1/3% support tests - 2016.
stop here.
33 1/3% support tests - 2015.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2016
Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975
Schedule A (Form 990 or 990-EZ) 2016 Page
(Complete only if you checked the box on line 10 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.)
2012 2013 2014 2015 2016 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Gross receipts from admissions,merchandise sold or services per-formed, or facilities furnished inany activity that is related to theorganization's tax-exempt purpose
Gross receipts from activities that
are not an unrelated trade or bus-
iness under section 513 ~~~~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
~~~ Add lines 1 through 5
Amounts included on lines 1, 2, and
3 received from disqualified persons
~~~~~~
Add lines 7a and 7b ~~~~~~~
2012 2013 2014 2015 2016 Total
Amounts from line 6 ~~~~~~~
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~
~~~~
Add lines 10a and 10b ~~~~~~Net income from unrelated businessactivities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~Other income. Do not include gainor loss from the sale of capitalassets (Explain in Part VI.) ~~~~
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 ���������������������������������������������������� |
Public support percentage for 2016 (line 8, column (f) divided by line 13, column (f))
Public support percentage from 2015 Schedule A, Part III, line 15
~~~~~~~~~~~~ %
%��������������������
Investment income percentage for (line 10c, column (f) divided by line 13, column (f))
Investment income percentage from Schedule A, Part III, line 17
~~~~~~~~ %
%~~~~~~~~~~~~~~~~~~
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 The organization qualifies as a publicly supported organization ~~~~~~~~~~ |
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 The organization qualifies as a publicly supported organization ~~~~ |
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions �������� |
Part III Support Schedule for Organizations Described in Section 509(a)(2)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
Section D. Computation of Investment Income Percentage
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
15 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 4 Part IV I Supporting Organizations
(Complete only if you checked a box in line 12 on Part I. If you checked 1 2a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E. If you checked 1 2d of Part I, complete Sections A and D, and complete Part V.) Section A. All Supporting Organizations
Yes I No
1 Are all of the organization's supported organizations listed by name in the organization's governing
documents? If No, describe in Part VI how the supported organizations are designated. 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)? 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
(b) and (c) below. 3a
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 1 70(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 12a or 12b 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. 4b
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 1 70(c)(2)(B)
purposes. 4c 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 EIN
numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;
( i ii ) 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? 5c 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(c)(3)(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 10b below. 10a
b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to 10b
632024 09-21-16 Schedule A (Form 990 or 990-EZ) 2016 16
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632024 09-21-16
4
Yes No
1
2
3
4
5
6
7
8
9
10
1
2
3a
3b
3c
4a
4b
4c
5a
5b
5c
6
7
8
9a
9b
9c
10a
10b
a
b
c
a
b
c
a
b
c
a
b
c
a
b
Type I or Type II only.
Substitutions only.
Schedule A (Form 990 or 990-EZ) 2016
If "No," describe in how the supported organizations are designated. If designated by
class or purpose, describe the designation. If historic and continuing relationship, explain.
If "Yes," explain in how the organization determined that the supported
organization was described in section 509(a)(1) or (2).
If "Yes," answer
(b) and (c) below.
If "Yes," describe in when and how the
organization made the determination.
If "Yes," explain in what controls the organization put in place to ensure such use.
If
"Yes," and if you checked 12a or 12b in Part I, answer (b) and (c) below.
If "Yes," describe in how the organization had such control and discretion
despite being controlled or supervised by or in connection with its supported organizations.
If "Yes," explain in 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.
If "Yes,"
answer (b) and (c) below (if applicable). Also, provide detail in including (i) the names and EIN
numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;
(iii) 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).
If "Yes," provide detail in
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," answer 10b below.
(Use Schedule C, Form 4720, to
determine whether the organization had excess business holdings.)
Schedule A (Form 990 or 990-EZ) 2016 Page
(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Are all of the organization's supported organizations listed by name in the organization's governing
documents?
Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)?
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)?
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)?
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)
purposes?
Was any supported organization not organized in the United States ("foreign supported organization")?
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization?
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)?
Did the organization add, substitute, or remove any supported organizations during the tax year?
Was any added or substituted supported organization part of a class already
designated in the organization's organizing document?
Was the substitution the result of an event beyond the organization's control?
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?
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor
(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with
regard to a substantial contributor?
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
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))?
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?
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?
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)?
Did the organization have any excess business holdings in the tax year?
Part VI
Part VI
Part VI
Part VI
Part VI
Part VI
Part VI,
Part VI.
Part VI.
Part VI.
Part VI.
Part IV Supporting Organizations
Section A. All Supporting Organizations
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
16 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A (Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204
Yes I No
11 Has the organization accepted a gift or contribution from any of the following persons?
a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)
below, the governing body of a supported organization?
b A family member of a person described in (a) above? 1 1b
Section B.
1 Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the
tax year? If No, describe in Part VI how the supported organization(s) effectively operated, supervised, or
controlled the organization'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. 2 Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization? If Yes, explain in
Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated,
Section C. Type II
Were a majority of the organization's directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization's supported organization(s)? If No, describe in Part VI how control
or management of the supporting organization was vested in the same persons that controlled or managed
Section D. All Type III
1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of the
organization's tax year, (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? 2 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 organization(s). 3 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
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 The organization satisfied the Activities Test. Complete line 2 below.
b The organization is the parent of each of its supported organizations. Complete line 3 below.
c 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. Yes No
a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive? If Yes, then in Part VI identify
those supported organizations and explain how these 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 organization(s) 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? 632025 09-21-16 Schedule A (Form 990 or 990-EZ) 2016
17 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632025 09-21-16
5
Yes No
11
a
b
c
11a
11b
11c
Yes No
1
2
1
2
Yes No
1
1
Yes No
1
2
3
1
2
3
1
2
3
a
b
c
Yes No
a
b
a
b
2a
2b
3a
3b
Schedule A (Form 990 or 990-EZ) 2016
If "Yes" to a, b, or c, provide detail in
If "No," describe in how the supported organization(s) 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.
If "Yes," explain in
how providing such benefit carried out the purposes of the supported organization(s) that operated,
supervised, or controlled the supporting organization.
If "No," describe in how control
or management of the supporting organization was vested in the same persons that controlled or managed
the supported organization(s).
If "No," explain in how
the organization maintained a close and continuous working relationship with the supported organization(s).
If "Yes," describe in the role the organization's
supported organizations played in this regard.
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year
Complete below.
Complete below.
Describe in Part VI how you supported a government entity (see instructions).
If "Yes," then in
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.
If "Yes," explain in the
reasons for the organization's position that its supported organization(s) would have engaged in these
activities but for the organization's involvement.
Provide details in
If "Yes," describe in the role played by the organization in this regard.
Schedule A (Form 990 or 990-EZ) 2016 Page
Has the organization accepted a gift or contribution from any of the following persons?
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?
A family member of a person described in (a) above?
A 35% controlled entity of a person described in (a) or (b) above?
Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the
tax year?
Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization?
Were a majority of the organization's directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization's supported organization(s)?
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?
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?
The organization satisfied the Activities Test.
The organization is the parent of each of its supported organizations.
The organization supported a governmental entity.
Activities Test.
Did substantially all of the organization's activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive?
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?
Parent of Supported Organizations.
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?
Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each
of its supported organizations?
Part VI.
Part VI
Part VI
Part VI
Part VI
Part VI
(see instructions).
line 2
line 3
Answer (a) and (b) below.
Part VI identify
those supported organizations and explain
Part VI
Answer (a) and (b) below.
Part VI.
Part VI
(continued)Part IV Supporting Organizations
Section B. Type I Supporting Organizations
Section C. Type II Supporting Organizations
Section D. All Type III Supporting Organizations
Section E. Type III Functionally Integrated Supporting Organizations
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
17 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 6 Part V I Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations 1 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI.) See instructions. All
other Typ e III non-functionally integrated supporting organizations must complet e Sections A through E
Section A - Adjusted Net Income
1 Net short-term capital gain 2 Recoveries of prior-year distributions 3 Other gross income (see instructions) 4 Add lines 1 through 3 5 Depreciation and depletion 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 instr 7 Other expenses (see instructions)
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 Average monthly cash balances
c Fair market value of other non-exempt-use assets
d Total (add lines 1 a, 1 b, and 1 c)
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
(B) Current Year (A) Prior Year (optional)
1 2 3 4 5
6 7 8
(A) Prior Year
1a 1b 1c 1d
2 3
4 5 6 7
(B) Current Year (optional)
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1 ______________________ _______________________ 2 Enter 85% of line 1 2 _____________________ _____________________ 3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3 _____________________ _____________________ 4 Enter greater of line 2 or line 3 4 ______________________ _______________________ 5 Income tax imposed in prior year 5 _____________________ _____________________ 6 Distributable Amount. Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions) 6 _______________________ ________________________ 7 Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see
instructions).
Schedule A (Form 990 or 990-EZ) 2016
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632026 09-21-16
6
1 See instructions.
Section A - Adjusted Net Income
1
2
3
4
5
6
7
8
1
2
3
4
5
6
7
8Adjusted Net Income
Section B - Minimum Asset Amount
1
2
3
4
5
6
7
8
a
b
c
d
e
1a
1b
1c
1d
2
3
4
5
6
7
8
Total
Discount
Part VI
Minimum Asset Amount
Section C - Distributable Amount
1
2
3
4
5
6
7
1
2
3
4
5
6
Distributable Amount.
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI.) All
other Type III non-functionally integrated supporting organizations must complete Sections A through E.
(B) Current Year(optional)(A) Prior Year
Net short-term capital gain
Recoveries of prior-year distributions
Other gross income (see instructions)
Add lines 1 through 3
Depreciation and depletion
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)
Other expenses (see instructions)
(subtract lines 5, 6, and 7 from line 4)
(B) Current Year(optional)(A) Prior Year
Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
Average monthly value of securities
Average monthly cash balances
Fair market value of other non-exempt-use assets
(add lines 1a, 1b, and 1c)
claimed for blockage or other
factors (explain in detail in ):
Acquisition indebtedness applicable to non-exempt-use assets
Subtract line 2 from line 1d
Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,
see instructions)
Net value of non-exempt-use assets (subtract line 4 from line 3)
Multiply line 5 by .035
Recoveries of prior-year distributions
(add line 7 to line 6)
Current Year
Adjusted net income for prior year (from Section A, line 8, Column A)
Enter 85% of line 1
Minimum asset amount for prior year (from Section B, line 8, Column A)
Enter greater of line 2 or line 3
Income tax imposed in prior year
Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions)
Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see
instructions).
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
18 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A (Form 990 or 990-EZ) 2016 FOUNDATION
Part V I Type III Non-Functionally Integrated 509(a)(3) Supporting O 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
organizations, in excess of income from activity 3 Administrative expenses paid to accomplish exempt purposes of supported organizat
31-1580204 Page 7
Year
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 through 6 8 Distributions to attentive supported organizations to which the organization is responsive
(provide details in Part VI). See instructions 9 Distributable amount for 2016 from Section C, line 6
10 Line 8 amount divided by Line 9 amount
Section E - Distribution Allocations (see instructions)
1 Distributable amount for 2016 from Section C, line 6 2 Underdistributions, if any, for years prior to 2016 (reason-
able cause required- explain in Part VI). See instructions
(i)
Excess Distributions
(ii) (iii) Underdistributions Distributable
Pre-2016 Amount for 2016
a
c From 2013
d From 2014
e From 2015
g Applied to underdistributions of prior years
h Applied to 2016 distributable amount
i Carryover from 2011 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f. 4 Distributions for 2016 from Section D,
line 7: $
a Applied to underdistributions of prior years
b Applied to 2016 distributable amount
c Remainder. Subtract lines 4a and 4b from 4 5 Remaining underdistributions for years prior to 2016, if
any. Subtract lines 3g and 4a from line 2. For result greater
than zero, explain in Part VI. See instructions 6 Remaining underdistributions for 2016. Subtract lines 3h
and 4b from line 1. For result greater than zero, explain in
Part VI. See instructions 7 Excess distributions carryover to 2017. Add lines 3j
and 4c
a
c Excess from 2014
d Excess from 2015
e Excess from 2016
Schedule A (Form 990 or 990-EZ) 2016
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632027 09-21-16
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Section D - Distributions Current Year
1
2
3
4
5
6
7
8
9
10
Part VI
Total annual distributions.
Part VI
(i)
Excess Distributions
(ii)Underdistributions
Pre-2016
(iii)Distributable
Amount for 2016Section E - Distribution Allocations (see instructions)
1
2
3
4
5
6
7
8
a
b
c
d
e
f
g
h
i
j
Total
a
b
c
Excess distributions carryover to 2017.
a
b
c
d
e
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
Amounts paid to supported organizations to accomplish exempt purposes
Amounts paid to perform activity that directly furthers exempt purposes of supported
organizations, in excess of income from activity
Administrative expenses paid to accomplish exempt purposes of supported organizations
Amounts paid to acquire exempt-use assets
Qualified set-aside amounts (prior IRS approval required)
Other distributions (describe in ). See instructions
Add lines 1 through 6
Distributions to attentive supported organizations to which the organization is responsive
(provide details in ). See instructions
Distributable amount for 2016 from Section C, line 6
Line 8 amount divided by Line 9 amount
Distributable amount for 2016 from Section C, line 6
Underdistributions, if any, for years prior to 2016 (reason-
able cause required- explain in Part VI). See instructions
Excess distributions carryover, if any, to 2016:
From 2013
From 2014
From 2015
of lines 3a through e
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Carryover from 2011 not applied (see instructions)
Remainder. Subtract lines 3g, 3h, and 3i from 3f.
Distributions for 2016 from Section D,
line 7: $
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Remainder. Subtract lines 4a and 4b from 4
Remaining underdistributions for years prior to 2016, if
any. Subtract lines 3g and 4a from line 2. For result greater
than zero, explain in Part VI. See instructions
Remaining underdistributions for 2016. Subtract lines 3h
and 4b from line 1. For result greater than zero, explain in
Part VI. See instructions
Add lines 3j
and 4c
Breakdown of line 7:
Excess from 2013
Excess from 2014
Excess from 2015
Excess from 2016
(continued) Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
19 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 8 Part VI I Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 1 7a or 1 7b; Part III, line 12;
Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11 a, 11 b, and 11 c; 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.
SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME:
MISCELLANEOUS
2012 AMOUNT: $ 39,646.
2013 AMOUNT: $ 1,462,782.
2014 AMOUNT: $ 419,626.
2015 AMOUNT: $ 199,253.
2016 AMOUNT: $ 104,122.
CAFE REVENUE
2013 AMOUNT: $ 295,526.
2014 AMOUNT: $ 341,872.
2015 AMOUNT: $ 361,855.
2016 AMOUNT: $ 498,780.
SPEECH REVENUE
2012 AMOUNT: $ 1,482,088.
2013 AMOUNT: $ 1,784,748.
2014 AMOUNT: $ 3,629,585.
2015 AMOUNT: $ 357,500.
2016 AMOUNT: $ 0.
PRESIDENT IAL CENTER
2012 AMOUNT: $ 1,000,402.
FUNDRAI SING REVENUE
2012 AMOUNT: $ 121,653.
2013 AMOUNT: $ 364,151. 632028 09-21-16 Schedule A (Form 990 or 990-EZ) 2016
20 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632028 09-21-16
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Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
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 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V,Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information.(See instructions.)
Part VI Supplemental Information.
MISCELLANEOUS
2012 AMOUNT: $ 39,646.
2013 AMOUNT: $ 1,462,782.
2014 AMOUNT: $ 419,626.
2015 AMOUNT: $ 199,253.
2016 AMOUNT: $ 104,122.
CAFE REVENUE
2013 AMOUNT: $ 295,526.
2014 AMOUNT: $ 341,872.
2015 AMOUNT: $ 361,855.
2016 AMOUNT: $ 498,780.
SPEECH REVENUE
2012 AMOUNT: $ 1,482,088.
2013 AMOUNT: $ 1,784,748.
2014 AMOUNT: $ 3,629,585.
2015 AMOUNT: $ 357,500.
2016 AMOUNT: $ 0.
PRESIDENTIAL CENTER
2012 AMOUNT: $ 1,000,402.
FUNDRAISING REVENUE
2012 AMOUNT: $ 121,653.
2013 AMOUNT: $ 364,151.
FOUNDATION
SCHEDULE A, PART II, LINE 10, EXPLANATION FOR OTHER INCOME:
31-1580204BILL, HILLARY & CHELSEA CLINTON
20 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule A(Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 8 Part VI I Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 1 7a or 1 7b; Part III, line 12;
Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11 a, 11 b, and 11 c; 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.
2014 AMOUNT: $ 290,150.
2015 AMOUNT: $ 132,850.
2016 AMOUNT: $ 68,368.
CDI FARMING REVENUE
2013 AMOUNT: $ 512,414.
2014 AMOUNT: $ 426,586.
2015 AMOUNT: $ 955,766.
2016 AMOUNT: $ -455,185.
PARTNERSHIP INCOME
2012 AMOUNT: $ -179,533.
632028 09-21-16 Schedule A (Form 990 or 990-EZ) 2016 21
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632028 09-21-16
8
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
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 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V,Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information.(See instructions.)
Part VI Supplemental Information.
2015 AMOUNT: $ 132,850.
2016 AMOUNT: $ 68,368.
CDI FARMING REVENUE
2013 AMOUNT: $ 512,414.
2014 AMOUNT: $ 426,586.
2015 AMOUNT: $ 955,766.
2016 AMOUNT: $ -455,185.
PARTNERSHIP INCOME
2012 AMOUNT: $ -179,533.
FOUNDATION
2014 AMOUNT: $ 290,150.
31-1580204BILL, HILLARY & CHELSEA CLINTON
21 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
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 www.irs.gov/form990 .
OMB No. 1545-0047
2016 Name of the organization
BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
Organization type (check one):
Filers of: Section:
Employer identification number
31-1580204
Form 990 or 990-EZ
Form 990-PF
X 501 (c)( 3 ) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
501 (c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
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
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
X 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 1 70(b)(1 )(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 1 6a, or 1 6b, 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 1 h,
or (ii) Form 990-EZ, line 1. Complete Parts I and II.
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.
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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2016)
623451 10-18-16
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
623451 10-18-16
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(Form 990, 990-EZ,or 990-PF)
| 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 .
Name of the organization Employer identification number
Organization type
Filers of: Section:
not
General Rule Special Rule.
Note:
General Rule
Special Rules
(1) (2)
General Rule
Caution:
must
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
exclusively
exclusively
exclusively
nonexclusively
(check one):
Form 990 or 990-EZ 501(c)( ) (enter number) organization
4947(a)(1) nonexempt charitable trust treated as a private foundation
527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the or a
Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
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.
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 $5,000 or 2% of the amount on (i) Form 990, Part VIII, line 1h,
or (ii) Form 990-EZ, line 1. Complete Parts I and II.
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 for religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
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 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 religious, charitable, etc.,
purpose. Don't complete any of the parts unless the applies to this organization because it received
religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~ | $
An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF),
but it 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 doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA
www.irs.gov/form990
Schedule B Schedule of Contributors
2016
FOUNDATION 31-1580204
X 3
X
BILL, HILLARY & CHELSEA CLINTON
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) 2
Name of organization Employer identification number BILL, HILLARY & CHELSEA CLINTON
FOUNDATION 31-1580204
Part I Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) (b) (c) (d) No. Name, address, and ZIP + 4 Total contributions p e of contribution
1 Person X
Payroll $ 5,766,375. Noncash
(Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. Name, address, and ZIP + 4 Total contributions p e of contribution
2 Person X
Payroll $ 2,199,981. Noncash
(Complete Part II for noncash contributions.)
(a) (b) No. Name, address, and ZIP + 4
3 CL
(a) (b) No. Name, address, and ZIP + 4
(c) (d) Total contributions Type of contribution
Person X
Payroll
$ 4,984,270. Noncash
(Complete Part II for noncash contributions.)
(c) (d) Total contributions Type of contribution
Person Payroll
$ Noncash
(Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. e ss, and ZIP + 4 Total contributions Type of contribution
Person Payroll
$ Noncash
(Complete Part II for noncash contributions.)
(a) (b) (c) (d) No. e ss, and ZIP + 4 Total contributions Type of contribution
______ ____________________________________________________________ Person Payroll
_________________________________________________________ $ ____________________ Noncash
(Complete Part II for noncash contributions.)
623452 10-18-16 Schedule B (Form 990, 990-EZ, or 990-PF) (2016) 24
12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
623452 10-18-16
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
(See instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
2
Part I Contributors
1 X
5,766,375.
2 X
2,199,981.
3 X
4,984,270.
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
24 12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page 3 Name of organization Employer identification number
BILL, HILLARY & CHELSEA CLINTON
FOUNDATION 31-1580204
Part II Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) I I ( c )
No. (b) (d) I FMV (or estimate) from I Description of noncash property given Date received
(See instructions) Part I
(a) No.
from Part I
(b) Description of noncash property given
$ _______________________ _______________
(c) (d)
FMV (or estimate) Date received
(See instructions)
(a) No.
from Part I
(b) Description of noncash property given
$ _______________________ _______________
(c) (d)
FMV (or estimate) Date received
(See instructions)
(a) No.
from Part I
(b) Description of noncash property given
$ _______________________ _______________
(c) (d)
FMV (or estimate) Date received
(See instructions)
(a) No.
from Part I
(b) Description of noncash property given
$ _______________________ _______________
(c) (d)
FMV (or estimate) Date received
(See instructions)
(a) No.
from Part I
(b) Description of noncash property given
$ _______________________ _______________
(c) (d)
FMV (or estimate) Date received
(See instructions)
I $ I 623453 10-18-16 Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
25 12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
623453 10-18-16
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
(See instructions). Use duplicate copies of Part II if additional space is needed.
$
$
$
$
$
$
3
Part II Noncash Property
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
25 12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) 4
Name of organization Employer identification number
BILL, HILLARY & CHELSEA CLINTON
FOUNDATION 31-1580204
Part III 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 completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enterthis info. once.) |$
Use duplicate copies of Part III if additional space is needed. (a) No. f rom (b) Purpose of gift (c) Use of gift (d) Description of how gift is held P t I
(e) Transfer of gift
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 of transferor to transferee
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 of transferor to transferee
623454 10-18-16 Schedule B ( F orm 990, 990-EZ, or 990-PF) (2016) 26
12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(Enter this info. once.)
For organizations
completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year.
623454 10-18-16
Name of organization Employer identification number
religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 forthe year from any one contributor. (a) (e) and
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
Complete columns through the following line entry.
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
| $
Use duplicate copies of Part III if additional space is needed.
Exclusively
4
Part III
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
26 12411115 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
SCHEDULE D Supplemental Financial Statements (Form 990) | 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. Department of the Treasury | Attach to Form 990.
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
Part I Organizations Maintaining Donor Advised Fu or or organization answered Yes on Form 990, Part IV, line 6.
(a) Donor advised funds
OMB No. 1545-0047
2016 Open to Public
form990. Inspection
Employer identification number 31-1580204
c counts. Complete if the
(b) Funds and other accounts 1 Total number at end of year ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2 Aggregate value of contributions to (during year) 3 Aggregate value of grants from (during year) ~ 4 Aggregate value at end of year ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I 5 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes No 6 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 No Part II I Conservation Easements. Complete if the organization answered Yes on Form 990, Part IV, line 7. 1 Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education) Preservation of a historically important land area
Protection of natural habitat Preservation of a certified historic structure
Preservation of open space 2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year. Held at the End of the Tax Year
a Total number of conservation easements
b Total acreage restricted by conservation easements ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2b
c Number of conservation easements on a certified historic structure included in (a) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2c
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2d 3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax
year | ______________ 4 Number of states where property subject to conservation easement is located | _______________ 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes No 6 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 1 70(h)(4)(B)(i)
and section 1 70(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 I 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 Form 990, Part VIII, line 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | $
(ii) Assets included in Form 990, Part X ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | $ 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. Schedule D (Form 990) 2016 632051 08-29-16
27 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632051 08-29-16
Held at the End of the Tax Year
(Form 990) | 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
Open to PublicInspection
Name of the organization Employer identification number
(a) (b)
1
2
3
4
5
6
Yes No
Yes No
1
2
3
4
5
6
7
8
9
a
b
c
d
2a
2b
2c
2d
Yes No
Yes No
1
2
a
b
(i)
(ii)
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2016
Complete if the
organization answered "Yes" on Form 990, Part IV, line 6.
Donor advised funds Funds and other accounts
Total number at end of year
Aggregate value of contributions to (during year)
Aggregate value of grants from (during year)
Aggregate value at end of year
~~~~~~~~~~~~~~~
~~~~
~~~~~~
~~~~~~~~~~~~~
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control? ~~~~~~~~~~~~~~~~~~
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? ��������������������������������������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
Protection of natural habitat
Preservation of open space
Preservation of a historically important land area
Preservation of a certified historic structure
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year.
Total number of conservation easements
Total acreage restricted by conservation easements
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements on a certified historic structure included in (a)
Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register
~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 |
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
|
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
| $
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)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
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.
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:
Revenue included on Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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:
Revenue included on Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$����������������������������������� |
LHA
www.irs.gov/form990.
Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Part II Conservation Easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
SCHEDULE D Supplemental Financial Statements2016
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
27 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule D(Form 990) 2016 FOUNDATION 31-1580204 Page 2 Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 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 [1 Public exhibition d [1 Loan or exchange programs
b [1 Scholarly research e [1 Other _______________________________________________________
c [1 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? ������������ [1 Yes [1 No I Part IV I 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, PartX?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ [1 Yes [1 No
b If"Yes," explain the arrangement in Part XIII and complete the following table: ________________________
Amount
c Beginning balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 c ________________________
d Additions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 d
e Distributions during the year ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 e
f Ending bala n ce ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 f ________________________
2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ~~~~~ [1 Yes [1 No b If "Yes " ex lain t hearran ementin Part XIII Check here if th eex lanation has been rovided on Part XIII [ 1
if the organization answered "Yes" on Form 990, Part IV, line 10.
1a Beginningofyearbalance ~~~~~~~ 183,711,819. 150,791,965. 59,096,285. 267,491 . 250,000.
b Contributions ~~~~~~~~~~~~~~ 4,507,787. 32,921,313. 91,679,557. 58,763,848 . 17,491.
c Netinvestmentearnings, gains,and losses 5,019,534. -1,459. 16,123. 64,946 .
d Gra n ts or scholarships ~ ~ ~ ~ ~ ~ ~ ~ ~ 6,047,720.
e O t her expenditures for facili t ies
and programs ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
f Adminis t rative expenses ~ ~ ~ ~ ~ ~ ~ ~
g Endofyearbala n ce ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 8 7,191,420. 183,711,819. 150,791,965. 59,096,285 . 267,491. 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 | 97.27 %
c Temporarily restricted endowment | 2.73 %
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: Yes No
(i) unrelated organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(i) X
(ii) related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(ii) X
b If"Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? ~~~~~~~~~~~~~~~~~~~~ 3b 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part VI I Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11 a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment)
1a Land ~~~~~~~~~~~~~~~~~~~~ _______________
b Buildings ~~~~~~~~~~~~~~~~~~ .________________
c Leasehold improvements ~~~~~~~~~~ ._________________
d Equipment ~~~~~~~~~~~~~~~~~ .________________
(b) Cost or other basis (other)
943,690. 127,552,331.
8,644,485. 11,276,629.
(c) Accumulated depreciation
38,634,029. 6,332,751. 6,607,183.
(d) Book value
943,690. 88,918,302. 2,311,734. 4,669,446.
Total. Add lines 1 a through 1 e. | I 96,843,172.
Schedule D (Form 990) 2016
632052 08-29-16
28 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632052 08-29-16
3
4
5
a
b
c
d
e
Yes No
1
2
a
b
c
d
e
f
a
b
Yes No
1c
1d
1e
1f
Yes No
(a) (b) (c) (d) (e)
1
2
3
4
a
b
c
d
e
f
g
a
b
c
a
b
Yes No
(i)
(ii)
3a(i)
3a(ii)
3b
(a) (b) (c) (d)
1a
b
c
d
e
Total.
Schedule D (Form 990) 2016
(continued)
(Column (d) must equal Form 990, Part X, column (B), line 10c.)
Two years back Three years back Four years back
Schedule D (Form 990) 2016 Page
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):
Public exhibition
Scholarly research
Preservation for future generations
Loan or exchange programs
Other
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
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? ������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 9, orreported an amount on Form 990, Part X, line 21.
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X?
If "Yes," explain the arrangement in Part XIII and complete the following table:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amount
Beginning balance
Additions during the year
Distributions during the year
Ending balance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII
~~~~~
�������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
Current year Prior year
Beginning of year balance
Contributions
Net investment earnings, gains, and losses
Grants or scholarships
~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~
Other expenditures for facilities
and programs
Administrative expenses
End of year balance
~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment
Permanent endowment
Temporarily restricted endowment
The percentages on lines 2a, 2b, and 2c should equal 100%.
| %
| %
| %
Are there endowment funds not in the possession of the organization that are held and administered for the organization
by:
unrelated organizations
related organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R?
Describe in Part XIII the intended uses of the organization's endowment funds.
~~~~~~~~~~~~~~~~~~~~
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property Cost or otherbasis (investment)
Cost or otherbasis (other)
Accumulateddepreciation
Book value
Land
Buildings
Leasehold improvements
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Equipment
Other
~~~~~~~~~~~~~~~~~
��������������������
Add lines 1a through 1e. |�������������
2Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets
Part IV Escrow and Custodial Arrangements.
Part V Endowment Funds.
Part VI Land, Buildings, and Equipment.
183,711,819.4,507,787.5,019,534.6,047,720.
187,191,420.
97.27
2.73
XX
943,690.127,552,331.8,644,485.11,276,629.
38,634,029.6,332,751.6,607,183.
943,690.88,918,302.2,311,734.4,669,446.
96,843,172.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
150,791,965.32,921,313.
-1,459.
183,711,819.
91,679,557.59,096,285.
16,123.
150,791,965.
267,491.58,763,848.
64,946.
59,096,285.
250,000.17,491.
267,491.
28 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule D(Form 990) 2016 FOUNDATION 31-1580204 Page 3 Part VII Investments - Other Securities.
Complete if the organization answered Yes on Form 990, Part IV, line 11 b. See Form 990, Part X, line 12. (a) Description of security or category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .____________________ ______________________________________________________
(2) Closely-held equity interests ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .____________________ ______________________________________________________
(3) Other ______________________________________ ____________________ ______________________________________________________
(A) HEDGED EQUITY 15,358,074. END-OF-YEAR MARKET VALUE
(B) SELECT EQUITY 41,984,831. END-OF-YEAR MARKET VALUE
(C) INTERMEDIATE FUND 17,207,593. END-OF-YEAR MARKET VALUE
(D) STRATEGIC FIXED INCOME 12,490,276. END-OF-YEAR MARKET VALUE
(E) PRIVATE EQUITY 2,674,527. END-OF-YEAR MARKET VALUE
(F) DIVERSIFIED STRATEGY FUNDS
15,503,615. END-OF-YEAR MARKET VALUE
105,218,916.
Investments - Program Related.
Complete if the organization answered Yes on Form 990, Part IV, line 11d. See Form 990, Part X, line 15. (a) Description I (b) Book value
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 X
Schedule D (Form 990) 2016
632053 08-29-16
29 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(including name of security)
632053 08-29-16
Total.
Total.
(a) (b) (c)
(1)
(2)
(3)
(a) (b) (c)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(a) (b)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total.
(a) (b) 1.
Total.
2.
Schedule D (Form 990) 2016
(Column (b) must equal Form 990, Part X, col. (B) line 15.)
(Column (b) must equal Form 990, Part X, col. (B) line 25.)
Description of security or category
(Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
(Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Schedule D (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
Book value Method of valuation: Cost or end-of-year market value
Financial derivatives
Closely-held equity interests
Other
~~~~~~~~~~~~~~~
~~~~~~~~~~~
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.Description of investment Book value Method of valuation: Cost or end-of-year market value
Complete if the organization answered "Yes" on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
Description Book value
���������������������������� |
Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
Description of liability Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Federal income taxes
����� |
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
3Part VII Investments - Other Securities.
Part VIII Investments - Program Related.
Part IX Other Assets.
Part X Other Liabilities.
SELECT EQUITYINTERMEDIATE FUNDSTRATEGIC FIXED INCOMEPRIVATE EQUITYDIVERSIFIED STRATEGY FUNDS
FOUNDATION
15,358,074.41,984,831.17,207,593.12,490,276.2,674,527.15,503,615.
31-1580204
105,218,916.
END-OF-YEAR MARKET VALUEEND-OF-YEAR MARKET VALUEEND-OF-YEAR MARKET VALUEEND-OF-YEAR MARKET VALUEEND-OF-YEAR MARKET VALUEEND-OF-YEAR MARKET VALUE
BILL, HILLARY & CHELSEA CLINTON
HEDGED EQUITY
X
29 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule D(Form 990) 2016 FOUNDATION 31-1580204 Page 4 Part XI I 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 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 ____________________
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2a
b Donated services and use of facilities ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2b
c Recoveries of prior year grants ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2c
d Other (Describe in Part XIII.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2d
e Add lines 2a through 2d ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2e 3 Subtract line 2e from line 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3 ___________________
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 ~ ~ ~ ~ ~ ~ ~ ~ 4a
b Other (Describe in Part XIII.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4b
c Add lines 4a and 4b ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4c __________________
PartXII Reconciliation of Expenses per Audited Financial Stateme per Complete if the organization answered Yes on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2a ________________________
~ 2b b Prior year adjustments ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
c Other losses ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2c __________________________
~ ~ 2d d Other (Describe in Part XIII.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
e Add lines 2a through 2d ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2e 3 Subtract line 2e from line 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b ~ ~ ~ ~ ~ ~ ~ ~
b Other (Describe in Part XIII.) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4b
c Add lines 4a and 4b ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 4c 5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I , line 18.) � � � � � � � � � � � � � � � � 5
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1 a 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 X, LINE 2:
MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE CONSOLIDATED ENTITIES
AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2016, THERE ARE NO UNCERTAIN
TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION
OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
FORM 990, SCHEDULE D, PART V, LINE 4
THE ENDOWMENT CONSISTS OF FUNDS ESTABLISHED TO SUPPORT THE ONGOING MISSION
OF THE BILL, HILLARY & CHELSEA CLINTON FOUNDATION.
632054 08-29-16 Schedule D (Form 990) 2016
30 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632054 08-29-16
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d 2e
32e 1
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d
2e 1
2e
3
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
Schedule D (Form 990) 2016
(This must equal Form 990, Part I, line 12.)
(This must equal Form 990, Part I, line 18.)
Schedule D (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Total revenue, gains, and other support per audited financial statements
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
~~~~~~~~~~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Recoveries of prior year grants
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total revenue. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
�����������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Total expenses and losses per audited financial statements
Amounts included on line 1 but not on Form 990, Part IX, line 25:
~~~~~~~~~~~~~~~~~~~~~~~~~~
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through
Subtract line from line
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total expenses. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
����������������
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a 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.
4Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Part XIII Supplemental Information.
MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE CONSOLIDATED ENTITIES
AND HAS CONCLUDED THAT, AS OF DECEMBER 31, 2016, THERE ARE NO UNCERTAIN
TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION
OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
FORM 990, SCHEDULE D, PART V, LINE 4
THE ENDOWMENT CONSISTS OF FUNDS ESTABLISHED TO SUPPORT THE ONGOING MISSION
PART X, LINE 2:
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
OF THE BILL, HILLARY & CHELSEA CLINTON FOUNDATION.
30 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule D(Form 990) 2016 FOUNDATION 31-1580204 Page 5 Part XIII Supplemental Information (continued)
Schedule D (Form 990) 2016 632055 08-29-16
31 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632055 08-29-16
5
Schedule D (Form 990) 2016
(continued)Schedule D (Form 990) 2016 Page Part XIII Supplemental Information
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
31 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
SCHEDULE F (Form 990)
Department of the Treasury Internal Revenue Service
Statement of Activities Outside the United States OMB No. 1 5 4 5 - 0 0 4 7
| Complete if the organization answered "Yes" on Form 990, Part IV, line 14b, 15, or 16. 2016 | Attach to Form 990. Open to Public
| Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990. Inspection
Name of the organization Employer identification number BILL, HILLARY & CHELSEA CLINTON
FOUNDATION 31-1580204
Part I I General Information on Activities Outside the United States. Complete if the organization answered "Yes" on
Form 990, Part IV, line 1 4b. 1 For grantmakers. Does the organization maintain records to substantiate the amount of its grants and other assistance,
the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance? ~~ X Yes No
2 For grantmakers. Describe in Part V the organization's procedures for monitoring the use of its grants and other assistance outside the
United States. 3 Activities per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of (c) Number of (d) Activities conducted in the region (e) If activity listed in (d) (f) Total offices employees, (by type) (such as, fundraising, pro- is a program service, expenditures
agents,and in the region independent gram services, investments, grants to describe specific type forand
contractors investments recipients located in the region) of service(s) in the region
intheregion in the region
CENTRAL AMERICA AND & ECONOMIC
THE CARIBBEAN 0 7 SERVICE 3,120,252.
EAST ASIA AND THE
PACIFIC 0 4 SERVICE 271,727.
SOUTH AMERICA 2 59 SERVICE C DEVELOPMENT I 8,029,751.
SOUTH ASIA 0 2 SERVICE 55,317.
& ECONOMIC
SUB-SAHARAN AFRICA 8 239 SERVICE 9,989,643.
3 a Sub-total ~~~~~~ 10 311 21,466,690.
b Total from continuation
sheets to Part I ~~~ 0 0 0.
c Totals (add lines 3a
and 3b) ������ 10 311 21,466,690.
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2016
632071 09-21-16
32 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632071 09-21-16
| Complete if the organization answered "Yes" on Form 990, Part IV, line 14b, 15, or 16.
| Attach to Form 990.
| Information about Schedule F (Form 990) and its instructions is at Open to Public Inspection
Employer identification number
1
2
3
For grantmakers.
Yes No
For grantmakers.
(a) (b) (c) (d) (e) (f)
3 a
b
c Totals
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2016
Name of the organization
Complete if the organization answered "Yes" on
Form 990, Part IV, line 14b.
Does the organization maintain records to substantiate the amount of its grants and other assistance,
the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance? ~~
Describe in Part V the organization's procedures for monitoring the use of its grants and other assistance outside the
United States.
Activities per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
Region Number ofoffices
in the region
Number ofemployees,agents, andindependentcontractorsin the region
Activities conducted in the region(by type) (such as, fundraising, pro-
gram services, investments, grants torecipients located in the region)
If activity listed in (d)is a program service,describe specific type
of service(s) in the region
Totalexpenditures
for andinvestmentsin the region
Sub-total ~~~~~~
Total from continuation
sheets to Part I ~~~
(add lines 3a
and 3b) ������
LHA
www.irs.gov/form990.
(Form 990)
Part I General Information on Activities Outside the United States.
SCHEDULE F Statement of Activities Outside the United States2016
3,120,252.
271,727.
8,029,751.
55,317.
9,989,643.
PROGRAM SERVICE DEVLOPMENT
PROGRAM SERVICE
PROGRAM SERVICE
PROGRAM SERVICE
PROGRAM SERVICE
21,466,690.
CLIMATE & ECONOMIC
CLIMATE
ECONOMIC DEVELOPMENT
CLIMATE
DEVLOPMENT
CENTRAL AMERICA AND7
4
59
2
239
311
0
0
2
0
8
EAST ASIA AND THE
10
THE CARIBBEAN
PACIFIC
SOUTH AMERICA
SOUTH ASIA
SUB-SAHARAN AFRICA
X
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
CLIMATE & ECONOMIC
0 0.
311 21,466,690.
0
10
32 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule F(Form 990) 2016 FOUNDATION 31-1580204 Page 2
I Part II I Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered Yes on Form 990, Part IV, line 15, for any
recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 I I I I I (b) IRS code section I (d) Purpose of I (e) Amount I (f) Manner of (g) Amount of I (h) Description I (i) Method of
(a) Name of organization (c) Region noncash of noncash valuation (book, FMV, and EIN (if applicable) grant of cash grant cash disbursement assistance assistance appraisal, other)
RAL AMERICA
THE CARIBBEAN A GRICULTURE
RAL AMERICA
THE CARIBBEAN F INANCIAL LITERACY
RAL AMERICA
THE CARIBBEAN LITERACY
SAHARAN
CA E DUCATION
50,000.
61,850.
10,000.
90,156.
0.
0.
0.
0.
SAHARAN
CA ON 40,307. 0.
PE (INCLUDING
AND &
NLAND) 6,721. 0.
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by
the IRS, or for which the grantee or counsel has provided a section 501 (c)(3) equivalency letter ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | 4 3 Enter total number of other organizations or entities � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � | 2
Schedule F (Form 990) 2016
632072 09-21-16
33 632072 09-21-16
2
Part II Grants and Other Assistance to Organizations or Entities Outside the United States.
(a) (b)
(c) (d) (e) (f) (g) (h) (i) 1
2
3
Schedule F (Form 990) 2016
IRS code section
and EIN (if applicable)
Schedule F (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any
recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
Name of organization RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnoncash
assistance
Descriptionof noncashassistance
Method ofvaluation (book, FMV,
appraisal, other)
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by
the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ~~~~~~~~~~~~~~~~~~~~~~~ |
Enter total number of other organizations or entities ��������������������������������������������� |
CENTRAL AMERICAAND THE CARIBBEAN AGRICULTURE 50,000. 0.
CENTRAL AMERICAAND THE CARIBBEAN FINANCIAL LITERACY 61,850. 0.
CENTRAL AMERICAAND THE CARIBBEAN LITERACY 10,000. 0.
SUB-SAHARANAFRICA EDUCATION 90,156. 0.
SUB-SAHARANAFRICA EDUCATION 40,307. 0.
EUROPE (INCLUDINGICELAND &GREENLAND) CLIMATE 6,721. 0.
42
WIRE
WIRE
WIRE
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
WIRE
WIRE
WIRE
33
BILL, HILLARY & CHELSEA CLINTON
Schedule F(Form 990) 2016 FOUNDATION 31-1580204 Page 3
Part III Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered Yes on Form 990, Part IV, line 16.
Part III can be
(a) Type of grant or assistance
if additional space is needed.
(c) Number of I (d) Amount of I (e) Manner of (b) Region recipients cash grant I cash disbursement
(f) Amount of I (g) Description of I (h) Method of noncash I noncash assistance I valuation
assistance I I (book, FMV,
Schedule F (Form 990) 2016
632073 09-21-16
34 632073 09-21-16
3
Part III Grants and Other Assistance to Individuals Outside the United States.
(c) (d) (e) (f) (g) (h) (a) (b)
Schedule F (Form 990) 2016
Schedule F (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
Number ofrecipients
Amount ofcash grant
Manner ofcash disbursement
Amount ofnoncash
assistance
Description ofnoncash assistance
Method ofvaluation
(book, FMV,appraisal, other)
Type of grant or assistance Region
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
34
BILL, HILLARY & CHELSEA CLINTON
Schedule F(Form 990) 2016 FOUNDATION 31-1580204 Page 4
Part IV I Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If Yes, the
organization maybe required to file Form 926, Return by a U.S. Transferor of Property to a Foreign
Corporation (see Instructions for Form 926) ............................................................................................................ X Yes No
2 Did the organization have an interest in a foreign trust during the tax year? If Yes, the organization
may be required to separately file Form 3520, Annual Return To Report Transactions With Foreign
Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign
Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990) .............................. Yes X No
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If Yes,
the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect To
Certain Foreign Corporations (see Instructions for Form 5471) ................................................................................. X Yes No
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a
qualified electing fund during the tax year? If Yes, the organization may be required to file Form 8621,
Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund
(see Instructions for Form 8621) ........................................................................................................................... Yes X No
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If Yes,
the organization may be required to file Form 8865, Return of U.S. Persons With Respect to Certain
Foreign Partnerships (see Instructions for Form 8865) ............................................................................................. X Yes No
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If
Yes, the organization may be required to separately file Form 5713, International Boycott Report (see
Instructions for Form 5713; do not file with Form 990) ............................................................................................. Yes X No
Schedule F (Form 990) 2016
632074 09-21-16
35 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632074 09-21-16
4
1
2
3
4
5
6
Schedule F (Form 990) 2016
If "Yes," the
organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign
Corporation (see Instructions for Form 926)
If "Yes," the organization
may be required to separately file Form 3520, Annual Return To Report Transactions With Foreign
Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign
Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)
If "Yes,"
the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect To
Certain Foreign Corporations (see Instructions for Form 5471)
If "Yes," the organization may be required to file Form 8621,
Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund
(see Instructions for Form 8621)
If "Yes,"
the organization may be required to file Form 8865, Return of U.S. Persons With Respect to Certain
Foreign Partnerships (see Instructions for Form 8865)
If
"Yes," the organization may be required to separately file Form 5713, International Boycott Report (see
Instructions for Form 5713; do not file with Form 990)
Schedule F (Form 990) 2016 Page
Was the organization a U.S. transferor of property to a foreign corporation during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have an interest in a foreign trust during the tax year?
~~~~~~~~~~ Yes No
Did the organization have an ownership interest in a foreign corporation during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Was the organization a direct or indirect shareholder of a passive foreign investment company or a
qualified electing fund during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have an ownership interest in a foreign partnership during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have any operations in or related to any boycotting countries during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Part IV Foreign Forms
X
X
X
X
X
X
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
35 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule F(Form 990) 2016 FOUNDATION 31-1580204 Page 5 Part V Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f ) (accounting method; amounts of
investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c)
(estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
PART I, LINE 2:
THE ORGANIZATION REQUIRES A FINAL REPORT FROM ALL GRANT RECIPIENTS
DETAILING THE USE OF GRANT FUNDS . THE RELEVANT GROUP INITIATIVE WITHIN
THE FOUNDATION REVIEWS THESE REPORTS FOR PROPER USE OF GRANT FUNDS AND
CONTINUED FUNDING.
FORM 990, SCHEDULE F, PART I, LINE 3, COLUMN (F)
EXPENDITURES ARE REPORTED ON AN ACCRUAL-BASIS CONSISTENT WITH THE
ORGANIZATION 'S FINANCIAL STATEMENTS.
632075 09-21-16 Schedule F (Form 990) 2016 36
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632075 09-21-16
5
Schedule F (Form 990) 2016
Schedule F (Form 990) 2016 Page
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of
investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c)
(estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
Part V Supplemental Information
PART I, LINE 2:
THE ORGANIZATION REQUIRES A FINAL REPORT FROM ALL GRANT RECIPIENTS
DETAILING THE USE OF GRANT FUNDS. THE RELEVANT GROUP INITIATIVE WITHIN
THE FOUNDATION REVIEWS THESE REPORTS FOR PROPER USE OF GRANT FUNDS AND
CONTINUED FUNDING.
FORM 990, SCHEDULE F, PART I, LINE 3, COLUMN (F)
EXPENDITURES ARE REPORTED ON AN ACCRUAL-BASIS CONSISTENT WITH THE
ORGANIZATION'S FINANCIAL STATEMENTS.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
36 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
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, line 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.irs.gov/form990.
OMB No. 1545-0047
2016 Open to Public Inspection
BILL, HILLARY & CHELSEA CLINTON Employer identification number FOUNDATION 31-1580204
Part I Fundraising Activities. Complete if the organization answered Yes on Form 990, Part IV, line 17. Form 990-EZ filers are not required to complete this part.
1 Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a LIIX Mail solicitations e LIIX Solicitation of non-government grants
b LIIX Internet and email solicitations f LIIX Solicitation of government grants
c LIIX Phone solicitations g LIIX Special fundraising events
d LIIX 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? LIIX Yes
b If Yes, list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
LII No
(i) Name and address of individual or entity (fund raiser)
(ii) Activity (iii) Did (v) Amount paid I
fun d r aiser (iv) Gross receipts to (or retained by) (vi) Amoun t paid I have custody to (o d by)
orcontrolof from ac t ivi t y fundr a iser r retaine ion contributions? listed in col t . orga n iza (i)
ANNE LEWI S DBA ANNE LEWI S Yes No STRATEGIES - 1140 19TH ST INE EMAIL MARKETING X 1,407,961. 50,064. 1,357,897.
AB DATA - PO BOX 170062,
MILWAUKEE , WI 53217-8000 IRECT MAIL MARKETING X 233,938. 97,500. 136,438.
1,641,899. 147,564. 1,494,335. 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. AL,AR,AK,AZ,CA,CO,CT,DE,DC,FL,GA,HI,ID, IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS
MO,MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,VT,VA,WA,WV,WI,WY
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2016 SEE PART IV FOR CONTINUATIONS
632081 09-12-16
37 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Didfundraiser
have custodyor control of
contributions?
632081 09-12-16
Information about Schedule G (Form 990 or 990-EZ) and its instructions is at
(Form 990 or 990-EZ)Complete if the organization answered "Yes" on Form 990, Part IV, line 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. Open to Public
Inspection| Employer identification number
1
a
b
c
d
a
b
e
f
g
2
Yes No
(i) (ii)
(iii) (iv)
(v)
(i)
(vi)
Yes No
Total
3
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2016
Name of the organization
Complete if the organization answered "Yes" on Form 990, Part IV, line 17. Form 990-EZ filers are notrequired to complete this part.
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
Mail solicitations
Internet and email solicitations
Phone solicitations
In-person solicitations
Solicitation of non-government grants
Solicitation of government grants
Special fundraising events
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?
If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
Name and address of individualor entity (fundraiser)
ActivityGross receipts
from activity
Amount paidto (or retained by)
fundraiserlisted in col.
Amount paidto (or retained by)
organization
�������������������������������������� |
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registrationor licensing.
LHA
www.irs.gov/form990.
SCHEDULE GSupplemental Information Regarding Fundraising or Gaming Activities
Fundraising Activities. Part I
2016
BILL, HILLARY & CHELSEA CLINTON31-1580204
XXXX
XXX
X
AB DATA - PO BOX 170062,
AL,AR,AK,AZ,CA,CO,CT,DE,DC,FL,GA,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS
ANNE LEWIS DBA ANNE LEWISX
X 233,938.
1,641,899.
97,500.
147,564.
136,438.
1,494,335.
50,064.1,407,961.
MO,MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,VT,VA,WA,WV,WI,WY
STRATEGIES - 1140 19TH ST, 1,357,897.
FOUNDATION
ONLINE EMAIL MARKETING
MILWAUKEE, WI 53217-8000 DIRECT MAIL MARKETING
SEE PART IV FOR CONTINUATIONS
37 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Sc FO NDATION 3 -
REeevnsxnep
hedule G (Form 990 or 990-EZ) 2016 U 11580204
iDteusecer
Page 2
Part I I 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.
(a) Event #1 (b) Event #2 (c) Other events (d) Total events
(add col. (a) through WJC 70TH BIRTHDAY D C EVENT 6
col. (c)) (event type) (event type) (total number)
1 Grossreceipts ~~~~~~~~~~~~~~ 9,377,710. 1,307,619. 1,713,666. 12,398,995.
2 Less:Contributions ~~~~~~~~~~~ 9,342,010. 1,293,969. 1,694,648.
3 Grossincome(line 1 minus line 2) ���� 35,700. 13,650. 19,018.
4 Cash prizes ~~~~~~~~~~~~~~~
5 Noncash prizes ~~~~~~~~~~~~~
6 Rent/facilitycosts ~~~~~~~~~~~~ 102,007. 38,241. 3,667.
7 Food and beverages ~~~~~~~~~~ 83,117. 4,700. 0.
8 Entertainment ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 74,396 . 9,000 . 310 . 9 Otherdirectexpenses ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2 92,798 . 94,758 . 233,536 .
_________
10 Direct expense summary. Add lines 4 through 9 in column (d) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | 11 Net income summary. Subtract line 10 from line 3, column (d) � � � � � � � � � � � � � � � � � � � � � � � � |
Part I I I 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. __________________ __________________ _________________
R e n e e u v
(b) Pull tabs/instant (d) Total gaming (add (a) Bingo (c) O t her gaming
bingo/progressive bingo col. (a) through col. (c))
I
i D E ts x n
s e c e p
e r
2 Ca s h prizes ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
3 Noncash prizes ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ____________ .______
4 Rent/facility costs ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .___________
- 5 Other direct expenses � � � � � � � � � � ____________
I I Yes 6 Volunteer labor ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .I I No
7 Direct expense summary. Add lines 2 through 5 in column (d)
% I I Yes % I I Yes %
~ |
9 Enter the state(s) in which the organization conducts gaming activities: ______________________________________________________________
a Is the organization licensed to conduct gaming activities in each of these states? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes No
b If No, explain:
10a Were any of the organization's gaming licenses revoked, suspended, or terminated during the tax year? ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes No
b If Yes, explain:
632082 09-12-16 Schedule G (Form 990 or 990-EZ) 2016
38 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
12,330,627.
68,368.
143,915.
87,817.
83,706.
621,092.
936,530.
-868,162.
632082 09-12-16
2
(d)
(a)
(c)
(a) (b) (c)
1
2
3
4
5
6
7
8
9
10
11
(a) (b)
(c) (d)
(a) (c)
1
2
3
4
5
6
7
8
Yes Yes Yes
No No No
9
10
a
b
Yes No
a
b
Yes No
Schedule G (Form 990 or 990-EZ) 2016
Pull tabs/instantbingo/progressive bingo
Schedule G (Form 990 or 990-EZ) 2016 Page
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.
Total events
(add col. through
col. )
Reve
nu
e
Event #1 Event #2 Other events
(event type) (event type) (total number)
Gross receipts
Less: Contributions
~~~~~~~~~~~~~~
~~~~~~~~~~~
Gross income (line 1 minus line 2)
Direct
Exp
en
ses
����
Cash prizes
Noncash prizes
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Rent/facility costs ~~~~~~~~~~~~
Food and beverages
Entertainment
~~~~~~~~~~
~~~~~~~~~~~~~~
Other direct expenses ~~~~~~~~~~
Direct expense summary. Add lines 4 through 9 in column (d)
Net income summary. Subtract line 10 from line 3, column (d)
~~~~~~~~~~~~~~~~~~~~~~~~ |
������������������������ |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.
Reve
nu
e Bingo Other gamingTotal gaming (add
col. through col. )
Direct
Exp
en
ses
Gross revenue ��������������
Cash prizes
Noncash prizes
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Rent/facility costs
Other direct expenses
~~~~~~~~~~~~
����������
% % %
Volunteer labor ~~~~~~~~~~~~~
Direct expense summary. Add lines 2 through 5 in column (d)
Net gaming income summary. Subtract line 7 from line 1, column (d)
~~~~~~~~~~~~~~~~~~~~~~~~ |
��������������������� |
Enter the state(s) in which the organization conducts gaming activities:
Is the organization licensed to conduct gaming activities in each of these states?
If "No," explain:
~~~~~~~~~~~~~~~~~~~~
Were any of the organization's gaming licenses revoked, suspended, or terminated during the tax year?
If "Yes," explain:
~~~~~~~~~
Part II Fundraising Events.
Part III Gaming.
9,377,710.
9,342,010.
35,700.
102,007.
83,117.
1,307,619.
1,293,969.
13,650.
38,241.
4,700.
1,713,666.
1,694,648.
19,018.
3,667.
0.
12,398,995.
12,330,627.
68,368.
143,915.
87,817.
936,530.-868,162.
WJC 70TH BIRTHDAY DC EVENT 6
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
74,396.292,798.
9,000.94,758. 233,536. 621,092.
310. 83,706.
38 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule G (Form 990 or 990-EZ) 2016 FOUNDATION 31-1580204 Page 3 11 Does the organization conduct gaming activities with nonmembers? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes No 13 Indicate the percentage of gaming activity conducted in:
a The organization's facility ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13a %
b An outside facility ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13b % 14 Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name |
Address |
15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? ~ ~ ~ ~ ~ ~ Yes 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 | _______________
Gaming manager compensation | $
Description of services provided |
Director/officer Employee 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? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Yes 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 | $
I 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, 1 5c, 16, and 1 7b, as applicable. Also provide any additional information. See instructions
SCHEDULE G, PART I, LINE 2B, LIST OF TEN HIGHEST PAID FUNDRAISERS:
(I) NAME OF FUNDRAISER: ANNE LEWIS DBA ANNE LEWIS STRATEGIES
(I) ADDRESS OF FUNDRAISER: 1140 19TH ST, WASHINGTON, DC 20036
SCHEDULE G, PART I, LINE 1
ALL METHODS OF SOLICITATION HAVE BEEN CHECKED INCLUDING THOSE METHODS
USED EXCLUSIVELY BY FOUNDATION EMPLOYEES. HOWEVER THE PROFESSIONAL
FUNDRAISERS LISTED ON LINE 2 ARE ENGAGED ONLY IN THE FOLLOWING: (A) 632083 09-12-16 Schedule G (Form 990 or 990-EZ) 2016
39 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632083 09-12-16
3
11
12
13
14
15
Yes No
Yes No
a
b
13a
13b
Yes Noa
b
c
16
17
a
b
Yes No
Supplemental Information.
Schedule G (Form 990 or 990-EZ) 2016
Schedule G (Form 990 or 990-EZ) 2016 Page
Does the organization conduct gaming activities with nonmembers?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Indicate the percentage of gaming activity conducted in:
The organization's facility
An outside facility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ %
%~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name |
Address |
Does the organization have a contract with a third party from whom the organization receives gaming revenue?
If "Yes," enter the amount of gaming revenue received by the organization |
~~~~~~
$ and the amount
of gaming revenue retained by the third party | $
If "Yes," enter name and address of the third party:
Name |
Address |
Gaming manager information:
Name |
Gaming manager compensation |
Description of services provided |
$
Director/officer Employee Independent contractor
Mandatory distributions:
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 | $
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
Part IV
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
SCHEDULE G, PART I, LINE 2B, LIST OF TEN HIGHEST PAID FUNDRAISERS:
(I) NAME OF FUNDRAISER: ANNE LEWIS DBA ANNE LEWIS STRATEGIES
(I) ADDRESS OF FUNDRAISER: 1140 19TH ST, WASHINGTON, DC 20036
SCHEDULE G, PART I, LINE 1
ALL METHODS OF SOLICITATION HAVE BEEN CHECKED INCLUDING THOSE METHODS
USED EXCLUSIVELY BY FOUNDATION EMPLOYEES. HOWEVER THE PROFESSIONALFUNDRAISERS LISTED ON LINE 2 ARE ENGAGED ONLY IN THE FOLLOWING: (A)
39 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule G (Form 990 or 990-EZ) FOUNDATION 31-1580204 Page 4 Part IV Supplemental Information (continued)
MAIL SOLICITATIONS AND (B) INTERNET AND EMAIL SOLICITATIONS.
Schedule G (Form 990 or 990-EZ) 632084 04-01-16
40 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
63208404-01-16
4
Schedule G (Form 990 or 990-EZ)
(continued)Schedule G (Form 990 or 990-EZ) Page Part IV Supplemental Information
FOUNDATION
MAIL SOLICITATIONS AND (B) INTERNET AND EMAIL SOLICITATIONS.
31-1580204BILL, HILLARY & CHELSEA CLINTON
40 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
SCHEDULE I (Form 990)
Department of the Treasury Internal Revenue Service
Grants and Other Assistance to Organizations, Governments, and Individuals in the United States
Complete if the organization answered "Yes" on Form 990, Part IV, line 21 or 22.
| Attach to Form 990.
Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form
OMB No. 1545-0047
2016 Open to Public
Inspection
Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number FOUNDATION 31-1580 204
General Information on Grants and Assistance 1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection
criteria used to award the grants or assistance? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ X Yes No 2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States. Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered Yes on Form 990, Part IV, line 21, for any
recipient that received more than $5,000. Part II can be duplicated if additional space is needed. 1 (a) Name and address of organization (b) EIN (c) IRC section (d) Amount of (e) Amount of (f) Method of (g) Description of (h) Purpose of grant
v a l u a t ion ( b o o k , or government (if applicable) cash grant non-cash noncash assis t ance or assis t ance F M V , a p p raisal , assis t ance other)
ALLIANCE FOR A HEALTHIER
GENERATION - 10 G STREET #800 -
WASHINGTON, DC 20002 27-2028308 501(C)(3)
HAITIAN EDUCATION & LEADERSHIP
PROGRAM - 64 FULTON ST - NEW YORK,
NY 10038 02-0602245 501(C)(3)
J/P HAITAIN RELIEF ORGANIZATION
6022 WILSHIRE BLVD
LOS ANGELES, CA 90049 27-1703237 501(C)(3)
2,300,000. 0.
6,135. 0.
OBES ITY
100,000. 0.
67,492. 0.
I
WORLD RESOURCES INSTITUTE
10 G STREET #800
WASHINGTON, DC 20002 52-1257057 501(C)(3)
RESILENCY
2 Enter total number of section 501 (c)(3) and government organizations listed in the line 1 table ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ | 4. 3 Enter total number of other organizations listed in the line 1 table ...................................................................................................................................................... |
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 . Schedule I (Form 990) (2016)
632101 11-01-16
41
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
632101 11-01-16
SCHEDULE I(Form 990)
Complete if the organization answered "Yes" on Form 990, Part IV, line 21 or 22.
| Attach to Form 990.
| Information about Schedule I (Form 990) and its instructions is at
Open to PublicInspection
Employer identification number
General Information on Grants and AssistancePart I
1
2
Yes No
Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments.
(f) 1 (a) (b) (c) (d) (e) (g) (h)
2
3
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2016)
Name of the organization
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection
criteria used to award the grants or assistance? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any
recipient that received more than $5,000. Part II can be duplicated if additional space is needed.Method of
valuation (book,FMV, appraisal,
other)
Name and address of organizationor government
EIN IRC section(if applicable)
Amount ofcash grant
Amount ofnon-cash
assistance
Description ofnoncash assistance
Purpose of grantor assistance
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table
Enter total number of other organizations listed in the line 1 table
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
�������������������������������������������������� |
LHA
www.irs.gov/form990.
Grants and Other Assistance to Organizations,Governments, and Individuals in the United States 2016
BILL, HILLARY & CHELSEA CLINTONFOUNDATION
ALLIANCE FOR A HEALTHIER
TRAINING
27-2028308
02-0602245
27-1703237
52-1257057
HAITI RECONSTRUCTION
CLIMATE RESILENCY
501(C)(3)
501(C)(3)
501(C)(3)
501(C)(3)
2,300,000.
6,135.
100,000.
67,492.
0.
0.
0.
0.
CHILDHOOD OBESITY
HAITIAN EDUCATION & LEADERSHIP
J/P HAITAIN RELIEF ORGANIZATION
WORLD RESOURCES INSTITUTE
4.
X
GENERATION - 10 G STREET #800 -
PROGRAM - 64 FULTON ST - NEW YORK,
6022 WILSHIRE BLVD
10 G STREET #800
31-1580204
WASHINGTON, DC 20002
NY 10038
LOS ANGELES, CA 90049
WASHINGTON, DC 20002
41
BILL, HILLARY & CHELSEA CLINTON
Schedule I (Form 990) (2016) FOUNDATION 31-1580204 Page 2 Part III Grants and Other Assistance to Domestic Individuals. Complete if the organization answered Yes on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of (c) Amount of (d) Amount of non- (e) Method of valuation (f) Description of noncash assistance recipients cash grant cash assistance (book, FMV, appraisal, other)
PART I, LINE 2:
THE ORGANIZATION REQUIRES A FINAL REPORT FROM ALL GRANT RECIPIENTS
DETAILING THE USE OF GRANT FUNDS. THE RELEVANT GROUP INITIATIVE WITHIN THE
FOUNDATION REVIEWS THESE REPORTS FOR PROPER USE OF GRANT FUNDS AND
CONTINUED FUNDING.
632102 11-01-16 Schedule I (Form 990) (2016) 42
632102 11-01-16
2Part III Grants and Other Assistance to Domestic Individuals.
(e) (a) (b) (c) (d) (f)
Part IV Supplemental Information.
Schedule I (Form 990) (2016)
Schedule I (Form 990) (2016) Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duplicated if additional space is needed.
Method of valuation(book, FMV, appraisal, other)
Type of grant or assistance Number ofrecipients
Amount ofcash grant
Amount of non-cash assistance
Description of noncash assistance
Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
PART I, LINE 2:
THE ORGANIZATION REQUIRES A FINAL REPORT FROM ALL GRANT RECIPIENTS
DETAILING THE USE OF GRANT FUNDS. THE RELEVANT GROUP INITIATIVE WITHIN THE
FOUNDATION REVIEWS THESE REPORTS FOR PROPER USE OF GRANT FUNDS AND
CONTINUED FUNDING.
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
42
SCHEDULE J (Form 990)
Department of the Treasury Internal Revenue Service
Name of the organization
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.irs.gov/f BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
OMB No. 1545-0047
2016 Open to Public
m 9 9 0 . Inspection
Employer identification number 31-1580204
I Yes I No 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 1 a. Complete Part III to provide any relevant information regarding these items. X First-class or charter travel Housing allowance or residence for personal use
Travel for companions Payments for business use of personal residence
Tax indemnification and gross-up payments Health or social club dues or initiation fees
Discretionary spending account Personal services (such as, 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 III to explain ~ ~ ~ ~ ~ ~ ~ ~ ~ X 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 on line 1 a? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ X
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.
Compensation committee X Written employment contract X Independent compensation consultant X Compensation survey or study X Form 990 of other organizations Approval by the board or compensation committee
4 During the year, did any person listed on Form 990, Part VII, Section A, line 1a, 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 1 a, did the organization pay or accrue any compensation
contingent on the revenues of:
a The organization? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
b Any related organization? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
If Yes on line 5a or 5b, describe in Part III. 6 For persons listed on Form 990, Part VII, Section A, line 1 a, 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 1 a, did the organization provide any nonfixed 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 on line 8, did the organization also follow the rebuttable presumption procedure described in
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
4a X
4b X
4c X
~ ~ ~ ~ 5a X
~ ~ ~ ~ 5b X
~ ~ ~ ~ 6a X
~ ~ ~ ~ 6b X
~ ~ ~ ~ ~ 7 X
~ ~ ~ ~ ~ 8 X
� _________ � � � � 9
Schedule J (Form 990) 2016
632111 09-09-16
43 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632111 09-09-16
For certain Officers, Directors, Trustees, Key Employees, and HighestCompensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.Open to Public
InspectionAttach to Form 990.
| Information about Schedule J (Form 990) and its instructions is at Employer identification number
Yes No
1a
b
1b
2
2
3
4
a
b
c
4a
4b
4c
Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
5a
5b
6a
6b
7
8
9
a
b
6
a
b
7
8
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2016
||
Name of the organization
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 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Travel for companions
Housing allowance or residence for personal use
Payments for business use of personal residence
Tax indemnification and gross-up payments
Discretionary spending account
Health or social club dues or initiation fees
Personal services (such as, maid, chauffeur, chef)
If any of the boxes on line 1a 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 III to explain ~~~~~~~~~~~
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 on line 1a? ~~~~~~~~~~~~
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.
Compensation committee
Independent compensation consultant
Form 990 of other organizations
Written employment contract
Compensation survey or study
Approval by the board or compensation committee
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing
organization or a related organization:
Receive a severance payment or change-of-control payment?
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
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.
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the revenues of:
The organization?
Any related organization?
If "Yes" on line 5a or 5b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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:
The organization?
Any related organization?
If "Yes" on line 6a or 6b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed payments
not described on lines 5 and 6? If "Yes," describe in Part III
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958-6(c)? ���������������������������������������������
LHA
www.irs.gov/form990.
SCHEDULE J(Form 990)
Part I Questions Regarding Compensation
Compensation Information
2016
BILL, HILLARY & CHELSEA CLINTON31-1580204
X
X
X
XX
XX
XXX
X
XX
XX
X
FOUNDATION
43 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule J(Form 990) 2016 FOUNDATION 31-1580204 Page 2 I Part II I Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
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 aren't 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 1 a, applicable column (D) and (E) amounts for that individual.
(B) Breakdown of W-2 and/or 1 099-MISC compensation (C) Retirement and (D) Nontaxable (E) Total of columns (F) Compensation other deferred benefits (B)(i)-(D) in column (B)
(i) Base (ii) Bonus & (iii) Other (A) Name and T i tle compensa t ion repor t ed as deferred
compensation incentive reportable on p rior Form 990 compensat ion compensat ion
(1) BRUCE R LINDSEY DIRECTOR (2) ANDREW KESSEL CFO (3) KEVIN THURM COO, EVP (4) RICARDO CASTRO GENERAL COUNSEL (5) SCOTT CURRAN ASSISTANT SECRETARY (6) STEPHANIE S. STREETT EXECUTIVE DIRECTOR, SECRETARY (7) DANIELLE STILZ CDO (8) MAURA PALLY SVP PROGRAMS (9) ROBERT S. HARRISON CEO, CGI (10) AMITABH DESAI FOREIGN POLICY DIRECTOR (11) CAROLINA BOTERO CFO, CGEP (12) DAVID WATT DIRECTOR OF SPONSORSHIP, CGI (13) DYMPHNA VAN DER LANS CEO, CCI (14) MARK GUNTON CEO, CGEP
(i) 361,230. 0. 78. 15,900. 26,484. 403,692. 0.
( - i i ) 0. 0. 0. 0. 0. 0. 0.
(i) 190,081. 0. 78. 11,590. 26,484. 228,233. 0.
( - i i ) 0. 0. 0. 0. 0. 0. 0.
(i) 394,059. 0. 78. 15,900. 30,255. 440,292. 0.
( - i i ) 0. 0. 0. 0. 0. 0. 0.
(i) 268,140. 0. 78. 14,884. 24,898. 308,000. 0.
- (ii) 0. 0. 0. 0. 0. 0. 0.
(i) 115,600. 0. 56,626. 9,760. 17,062. 199,048. 0.
- (ii) 0. 0. 0. 0. 0. 0. 0.
(i) 192,119. 3,000. 78. 12,362. 27,195. 234,754. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 188,020. 3,000. 78. 16,076. 10,636. 217,810. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 298,746. 0. 334. 15,900. 10,317. 325,297. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 237,626. 3,000. 78. 12,931. 28,729. 282,364. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 204,490. 3,000. 333. 12,664. 26,823. 247,310. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 205,669. 3,000. 78. 12,540. 24,645. 245,932. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 264,415. 2,500. 334. 15,418. 28,241. 310,908. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 241,702. 3,000. 78. 12,431. 24,645. 281,856. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
(i) 284,409. 3,000. 349. 15,900. 26,205. 329,863. 0.
(ii) 0. 0. 0. 0. 0. 0. 0.
( i )
( i i )
( i )
Schedule J (Form 990) 2016 632112 09-09-16
44 632112 09-09-16
2
Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Note:
(B) (C) (D) (E) (F)
(i) (ii) (iii) (A)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Use duplicate copies if additional space is needed.
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 aren't listed on Form 990, Part VII.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
Breakdown of W-2 and/or 1099-MISC compensation Retirement andother deferredcompensation
Nontaxablebenefits
Total of columns(B)(i)-(D)
Compensationin column (B)
reported as deferredon prior Form 990
Basecompensation
Bonus &incentive
compensation
Otherreportable
compensation
Name and Title
BILL, HILLARY & CHELSEA CLINTONFOUNDATION
361,230. 0. 78. 15,900. 26,484. 403,692. 0.DIRECTOR 0. 0. 0. 0. 0. 0. 0.
190,081. 0. 78. 11,590. 26,484. 228,233. 0.CFO 0. 0. 0. 0. 0. 0. 0.
394,059. 0. 78. 15,900. 30,255. 440,292. 0.COO, EVP 0. 0. 0. 0. 0. 0. 0.
268,140. 0. 78. 14,884. 24,898. 308,000. 0.GENERAL COUNSEL 0. 0. 0. 0. 0. 0. 0.
115,600. 0. 56,626. 9,760. 17,062. 199,048. 0.ASSISTANT SECRETARY 0. 0. 0. 0. 0. 0. 0.
192,119. 3,000. 78. 12,362. 27,195. 234,754. 0.EXECUTIVE DIRECTOR, SECRETARY 0. 0. 0. 0. 0. 0. 0.
188,020. 3,000. 78. 16,076. 10,636. 217,810. 0.CDO 0. 0. 0. 0. 0. 0. 0.
298,746. 0. 334. 15,900. 10,317. 325,297. 0.SVP PROGRAMS 0. 0. 0. 0. 0. 0. 0.
237,626. 3,000. 78. 12,931. 28,729. 282,364. 0.CEO, CGI 0. 0. 0. 0. 0. 0. 0.
204,490. 3,000. 333. 12,664. 26,823. 247,310. 0.FOREIGN POLICY DIRECTOR 0. 0. 0. 0. 0. 0. 0.
205,669. 3,000. 78. 12,540. 24,645. 245,932. 0.CFO, CGEP 0. 0. 0. 0. 0. 0. 0.
264,415. 2,500. 334. 15,418. 28,241. 310,908. 0.DIRECTOR OF SPONSORSHIP, CGI 0. 0. 0. 0. 0. 0. 0.
241,702. 3,000. 78. 12,431. 24,645. 281,856. 0.CEO, CCI 0. 0. 0. 0. 0. 0. 0.
284,409. 3,000. 349. 15,900. 26,205. 329,863. 0.CEO, CGEP 0. 0. 0. 0. 0. 0. 0.
31-1580204
(1) BRUCE R LINDSEY
(2) ANDREW KESSEL
(3) KEVIN THURM
(4) RICARDO CASTRO
(5) SCOTT CURRAN
(6) STEPHANIE S. STREETT
(7) DANIELLE STILZ
(8) MAURA PALLY
(9) ROBERT S. HARRISON
(10) AMITABH DESAI
(11) CAROLINA BOTERO
(12) DAVID WATT
(13) DYMPHNA VAN DER LANS
(14) MARK GUNTON
44
BILL, HILLARY & CHELSEA CLINTON
Schedule J(Form 990) 2016 FOUNDATION 31-1580204 Page 3 I Part III I Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 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.
PART I, LINE 1A:
FORM 990, SCHEDULE J, PART I, LINE 1A
THE CLINTON FOUNDATION HAS A TRAVEL AND BUSINESS EXPENSE POLICY APPLICABLE
TO OFFICERS AND KEY EMPLOYEES AS PART OF ITS GLOBAL CODE OF CONDUCT. THE
POLICY PROVIDES THAT TRAVEL MUST BE BY THE 'LOWEST COMMERCIAL COACH CLASS
FARE,' WITH CERTAIN LIMITED EXCEPTIONS WHEN AIR TRAVEL EXCEEDS 9 HOURS OR
IS AN OVERNIGHT TRANSCONTINENTAL FLIGHT, AND THE TRAVELER MUST REPORT TO
WORK SOON AFTER ARRIVAL. IN THESE LIMITED CIRCUMSTANCES, TRAVEL MAY BE VIA
THE LOWEST COMMERCIAL CLASS ABOVE COACH CLASS, WHICH IS TYPICALLY BUSINESS
CLASS.
ON A CASE BY CASE BASIS, WILLIAM J. CLINTON AND CHELSEA V . CLINTON MAY HAVE
REQUIRED TRAVEL VIA FIRST CLASS. IN ADDITION, ON A CASE BY CASE BASIS DUE
TO SECURITY MEASURES, WILLIAM J. CLINTON MAY HAVE REQUIRED TRAVEL VIA
CHARTER
PART I, LINE 1B:
FORM 990, SCHEDULE J, PART I, LINE 2
Schedule J (Form 990) 2016
632113 09-09-16
45 632113 09-09-16
3
Part III Supplemental Information
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
PART I, LINE 1A:
FORM 990, SCHEDULE J, PART I, LINE 1A
TO OFFICERS AND KEY EMPLOYEES AS PART OF ITS GLOBAL CODE OF CONDUCT. THE
FARE," WITH CERTAIN LIMITED EXCEPTIONS WHEN AIR TRAVEL EXCEEDS 9 HOURS OR
WORK SOON AFTER ARRIVAL. IN THESE LIMITED CIRCUMSTANCES, TRAVEL MAY BE VIA
THE CLINTON FOUNDATION HAS A TRAVEL AND BUSINESS EXPENSE POLICY APPLICABLE
POLICY PROVIDES THAT TRAVEL MUST BE BY THE "LOWEST COMMERCIAL COACH CLASS
IS AN OVERNIGHT TRANSCONTINENTAL FLIGHT, AND THE TRAVELER MUST REPORT TO
THE LOWEST COMMERCIAL CLASS ABOVE COACH CLASS, WHICH IS TYPICALLY BUSINESS
CLASS.
ON A CASE BY CASE BASIS, WILLIAM J. CLINTON AND CHELSEA V. CLINTON MAY HAVE
REQUIRED TRAVEL VIA FIRST CLASS. IN ADDITION, ON A CASE BY CASE BASIS DUE
TO SECURITY MEASURES, WILLIAM J. CLINTON MAY HAVE REQUIRED TRAVEL VIA
CHARTER
PART I, LINE 1B:
FORM 990, SCHEDULE J, PART I, LINE 2
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
45
BILL, HILLARY & CHELSEA CLINTON
Schedule J(Form 990) 2016 FOUNDATION 31-1580204 Page 3 I Part III I Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 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.
ON A CASE BY CASE BASIS, WILLIAM J. CLINTON AND CHELSEA V. CLINTON MAY HAVE
REQUIRED TRAVEL VIA FIRST CLASS. IN ADDITION, ON A CASE BY CASE BASIS DUE
TO SECURITY MEASURES, WILLIAM J. CLINTON MAY HAVE REQUIRED TRAVEL VIA
CHARTER
PART I, LINE 4A:
SCOTT CURRAN RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENT IS
REPORTED ON PART II, COLUMN B(III).
FORM 990, SCHEDULE J, PART I, LINE 7
THE AMOUNTS INCLUDED IN PART II, COLUMN B(II) REPRESENT BONUSES THAT
WERE INCLUDED IN THE 2016 W-2.
Schedule J (Form 990) 2016
632113 09-09-16
46 632113 09-09-16
3
Part III Supplemental Information
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
ON A CASE BY CASE BASIS, WILLIAM J. CLINTON AND CHELSEA V. CLINTON MAY HAVE
REQUIRED TRAVEL VIA FIRST CLASS. IN ADDITION, ON A CASE BY CASE BASIS DUE
TO SECURITY MEASURES, WILLIAM J. CLINTON MAY HAVE REQUIRED TRAVEL VIA
SCOTT CURRAN RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENT IS
CHARTER
PART I, LINE 4A:
REPORTED ON PART II, COLUMN B(III).
FORM 990, SCHEDULE J, PART I, LINE 7
THE AMOUNTS INCLUDED IN PART II, COLUMN B(II) REPRESENT BONUSES THAT
WERE INCLUDED IN THE 2016 W-2.
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
46
Noncash Contributions
J Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
J Attach to Form 990.
J Information about Schedule M (Form 990) and its instructions is at www.irs.gov/for
OMB No. 1545-0047
2016 Open To Public
Inspection
SCHEDULE M (Form 990)
Department of the Treasury Internal Revenue Service
BILL, HILLARY & CHELSEA CLINTON Employer identification number FOUNDATION 31-1580204
(a) (b) (c) (d) Check if Number of Noncash contribution Method of determining
applicable contributions or amounts reported on noncash contribution amounts
1 Art - Works ofart ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _______ ___________ _______ 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 - Publiclytraded ~ ~ ~ ~ ~ ~ ~ ~ X 23
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 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ X 1 20 Drugs and medical supplies ~ ~ ~ ~ ~ ~ ~ ~ .________ _____________ _________ 21 Taxidermy ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .________ _____________ ________ 22 Historical artifacts ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ________ _____________ ________ 23 Scientific specimens ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .________ _____________ _________ 24 Archeological artifacts ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .________ _____________ ________ 25 Other J ( COMPUTER HARD ) X 1 26 Other J ( ______________________ ) ________ _____________ _________ 27 Other J ( _____________________ ) ________ _____________ ________ 28 Other J ( ) ________ _____________ _________ 29 Number of Forms 8283 received by the organization during the tax year for contributions
540,191.
4,754.
5,598.
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ~~~~ 29
30a During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it
must hold for at least three years from the date of the initial contribution, and which isn't 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 nonstandard contributions? ~ ~ 32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
b If Yes, describe in Part II. 33 If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
30a X
31 X
32a X
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2016)
632141 08-23-16
47 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632141 08-23-16
Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Open To PublicInspection
Attach to Form 990.
Information about Schedule M (Form 990) and its instructions is at Employer identification number
(a) (b) (c) (d)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
29
Yes No
30
31
32
33
a
b
30a
31
32a
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2016)
Name of the organization
Check ifapplicable
Number ofcontributions or
items contributed
Noncash contributionamounts reported on
Form 990, Part VIII, line 1g
Method of determiningnoncash contribution amounts
Art - Works of art
Art - Historical treasures
Art - Fractional interests
~~~~~~~~~~~~~
~~~~~~~~~
~~~~~~~~~~
Books and publications
Clothing and household goods
~~~~~~~~~~
~~~~~~
Cars and other vehicles
Boats and planes
Intellectual property
~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~
Securities - Publicly traded
Securities - Closely held stock
~~~~~~~~
~~~~~~~
Securities - Partnership, LLC, or
trust interests
Securities - Miscellaneous
~~~~~~~~~~~~~~
~~~~~~~~
Qualified conservation contribution -
Historic structures
Qualified conservation contribution - Other
~~~~~~~~~~~~
~
Real estate - Residential
Real estate - Commercial
Real estate - Other
~~~~~~~~~
~~~~~~~~~
~~~~~~~~~~~~
Collectibles
Food inventory
Drugs and medical supplies
Taxidermy
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~~~~~~~
Historical artifacts
Scientific specimens
Archeological artifacts
~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~
Other ( )
Other ( )
Other ( )
Other ( )
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ~~~~
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it
must hold for at least three years from the date of the initial contribution, and which isn't required to be used for
exempt purposes for the entire holding period? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," describe the arrangement in Part II.
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions? ~~~~~~
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," describe in Part II.
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
LHA
www.irs.gov/form990.
SCHEDULE M(Form 990)
Part I Types of Property
Noncash Contributions
2016J J J
JJJJ
BILL, HILLARY & CHELSEA CLINTON31-1580204
540,191.
4,754.
5,598.
23
1 1
FMV
FMV
FMV
X
X
XCOMPUTER HARD
X
X
X
FOUNDATION
47 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Schedule M (Form 990) (2016) FOUNDATION 31-1580204 Page 2 Part II 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):
COLUM B REPRESENTS NUMBER OF CONTRIBUTORS.
632142 08-23-16 Schedule M (Form 990) (2016)
48 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632142 08-23-16
2
Schedule M (Form 990) (2016)
Schedule M (Form 990) (2016) Page
Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organizationis reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also completethis part for any additional information.
Part II Supplemental Information.
SCHEDULE M, PART I, COLUMN (B):
COLUM B REPRESENTS NUMBER OF CONTRIBUTORS.
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
48 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
2016 Open to Public
SCHEDULE O Supplemental Information to Form 990 or 990-EZ (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. Department of the Treasury | Attach to Form 990 or 990-EZ.
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
FORM 990 PART I LINE 1
IMPROVE GLOBAL HEALTH & WELLNESS, INCREASE OPPORTUNITY FOR WOMEN/GIRLS,
REDUCE CHILDHOOD OBESTITY, CREATE ECONOMIC OPPORTUNITY & GROWTH AND
HELP COMMUNITIES ADDRESS EFFECTS OF CLIMATE CHANGE.
Employer identification number 31-1580204
FORM 990 PART III LINE 4A
THE CLINTON GLOBAL INITIATIVE'S (CGI) MISSION IS TO INSPIRE, CONNECT,
AND EMPOWER EVERYONE TO FORGE SOLUTIONS TO THE WORLD'S MOST PRESSING
CHALLENGES. THROUGH 2016, CGI HAS CONVENED LEADERS FROM THE PRIVATE
SECTOR, PUBLIC SECTOR, AND CIVIL SOCIETY TO DRIVE ACTION THROUGH ITS
UNIQUE MODEL. RATHER THAN DIRECTLY IMPLEMENTING PROJECTS, CGI HELPS ITS
MEMBERS TURN IDEAS INTO ACTION THROUGH IMPACTFUL AND MEASURABLE
COMMITMENTS TO ACTION. TO SUPPORT THE DEVELOPMENT OF COMMITMENTS
YEAR-ROUND, CGI FACILITATES CONVERSATIONS, PROVIDES OPPORTUNITIES TO
IDENTIFY PARTNERS, AND COMMUNICATES THE RESULTS OF THE WORK. SINCE CGI
WAS FORMED IN 2005, MEMBERS AND PARTNERS HAVE MADE MORE THAN 3,600
COMMITMENTS TO ACTION THAT HAVE IMPROVED THE LIVES OF MORE THAN 435
MILLION PEOPLE IN MORE THAN 180 COUNTRIES.
FORM 990 PART III LINE 4B
THE WILLIAM J. CLINTON PRESIDENTIAL CENTER IS THE HOME OF THE LITTLE
ROCK OFFICES OF THE CLINTON FOUNDATION; THE CLINTON PRESIDENTIAL
LIBRARY AND MUSEUM; THE CLINTON SCHOOL OF PUBLIC SERVICE, THE FIRST
INSTITUTION IN THE NATION TO OFFER A MASTER OF PUBLIC SERVICE (MPS)
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2016) 632211 08-25-16
49 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632211 08-25-16
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.
| Attach to Form 990 or 990-EZ.|
(Form 990 or 990-EZ)
Open to PublicInspection
Employer identification number
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2016)
Name of the organization
LHA
www.irs.gov/form990.
SCHEDULE O Supplemental Information to Form 990 or 990-EZ2016
FORM 990 PART I LINE 1
IMPROVE GLOBAL HEALTH & WELLNESS, INCREASE OPPORTUNITY FOR WOMEN/GIRLS,
REDUCE CHILDHOOD OBESTITY, CREATE ECONOMIC OPPORTUNITY & GROWTH AND
HELP COMMUNITIES ADDRESS EFFECTS OF CLIMATE CHANGE.
FORM 990 PART III LINE 4A
THE CLINTON GLOBAL INITIATIVE'S (CGI) MISSION IS TO INSPIRE, CONNECT,
AND EMPOWER EVERYONE TO FORGE SOLUTIONS TO THE WORLD'S MOST PRESSING
CHALLENGES. THROUGH 2016, CGI HAS CONVENED LEADERS FROM THE PRIVATE
SECTOR, PUBLIC SECTOR, AND CIVIL SOCIETY TO DRIVE ACTION THROUGH ITS
UNIQUE MODEL. RATHER THAN DIRECTLY IMPLEMENTING PROJECTS, CGI HELPS ITS
MEMBERS TURN IDEAS INTO ACTION THROUGH IMPACTFUL AND MEASURABLE
COMMITMENTS TO ACTION. TO SUPPORT THE DEVELOPMENT OF COMMITMENTS
YEAR-ROUND, CGI FACILITATES CONVERSATIONS, PROVIDES OPPORTUNITIES TO
IDENTIFY PARTNERS, AND COMMUNICATES THE RESULTS OF THE WORK. SINCE CGI
WAS FORMED IN 2005, MEMBERS AND PARTNERS HAVE MADE MORE THAN 3,600
COMMITMENTS TO ACTION THAT HAVE IMPROVED THE LIVES OF MORE THAN 435
MILLION PEOPLE IN MORE THAN 180 COUNTRIES.
FORM 990 PART III LINE 4B
THE WILLIAM J. CLINTON PRESIDENTIAL CENTER IS THE HOME OF THE LITTLE
ROCK OFFICES OF THE CLINTON FOUNDATION; THE CLINTON PRESIDENTIAL
LIBRARY AND MUSEUM; THE CLINTON SCHOOL OF PUBLIC SERVICE, THE FIRST
INSTITUTION IN THE NATION TO OFFER A MASTER OF PUBLIC SERVICE (MPS)
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
49 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016)
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
DEGREE; AND IS A MANAGING PARTNER OF THE PRESIDENTIAL LEADERSHIP
SCHOLARS PROGRAM, A NATIONAL BIPARTISAN EXECUTIVE-STYLE LEADERSHIP
DEVELOPMENT INITIATIVE. ADDITIONALLY, THE CLINTON CENTER IS A
WORLD-CLASS EDUCATIONAL AND CULTURAL VENUE OFFERING A VARIETY OF
EDUCATIONAL PROGRAMS, SPECIAL EVENTS, EXHIBITIONS, AND LECTURES,
PRESENTING A UNIQUE PERSPECTIVE OF THE WORK PAST, PRESENT, AND FUTURE
OF THE 42ND PRESIDENT OF THE UNITED STATES, WILLIAM JEFFERSON CLINTON.
BY THE END OF 2016, THE CENTER HAD WELCOMED MORE THAN FOUR MILLION
VISITORS, INCLUDING 327,600 STUDENTS AND TEACHERS WHO HAVE VISITED THE
CLINTON PRESIDENTIAL CENTER FREE OF CHARGE, AND AS OF OCTOBER 2014, THE
CENTER CATALYZED $3.3 BILLION IN ECONOMIC IMPACT IN THE DOWNTOWN AREAS
OF LITTLE ROCK AND NORTH LITTLE ROCK.
FORM 990 PART III LINE 4C
THE CLINTON GIUSTRA ENTERPRISE PARTNERSHIP (CGEP) BUILDS SOCIAL
BUSINESSES TO GENERATE SOCIAL IMPACT AND FINANCIAL RETURNS BY
ADDRESSING MARKET GAPS IN DEVELOPING COUNTRIES ' SUPPLY OR DISTRIBUTION
CHAINS. CGEP WORKS WITH SMALLHOLDER FARMERS, FISHERS, WOMEN
ENTREPRENEURS, AND YOUTH TO IMPROVE THEIR LIVELIHOODS BY PROVIDING THE
TOOLS THEY NEED FROM TRAINING AND FINANCING TO TECHNOLOGY AND
INNOVATION AND BRINGING THEM INTO MARKETS WHERE THEY CAN PROSPER. CGEP
INCORPORATES INDIVIDUALS INTO ONE OF THREE MARKET-DRIVEN MODELS SUPPLY
CHAIN BUSINESSES, INCLUSIVE DISTRIBUTION BUSINESSES, AND VOCATIONAL
TRAINING CENTER BUSINESSES. THROUGH THESE MODELS, CGEP SEEKS TO HELP
PEOPLE WORK THEMSELVES OUT OF POVERTY. IN 2016, CGEP EXPANDED ITS WORK
CONNECTING SMALLHOLDER FARMERS WITH HIGH-VALUE MARKETS.
632212 08-25-16
Page 2
Employer identification number 31-1580204
Schedule O (Form 990 or 990-EZ) (2016) 50
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
DEGREE; AND IS A MANAGING PARTNER OF THE PRESIDENTIAL LEADERSHIP
SCHOLARS PROGRAM, A NATIONAL BIPARTISAN EXECUTIVE-STYLE LEADERSHIP
DEVELOPMENT INITIATIVE. ADDITIONALLY, THE CLINTON CENTER IS A
WORLD-CLASS EDUCATIONAL AND CULTURAL VENUE OFFERING A VARIETY OF
EDUCATIONAL PROGRAMS, SPECIAL EVENTS, EXHIBITIONS, AND LECTURES,
PRESENTING A UNIQUE PERSPECTIVE OF THE WORK PAST, PRESENT, AND FUTURE
OF THE 42ND PRESIDENT OF THE UNITED STATES, WILLIAM JEFFERSON CLINTON.
BY THE END OF 2016, THE CENTER HAD WELCOMED MORE THAN FOUR MILLION
VISITORS, INCLUDING 327,600 STUDENTS AND TEACHERS WHO HAVE VISITED THE
CLINTON PRESIDENTIAL CENTER FREE OF CHARGE, AND AS OF OCTOBER 2014, THE
CENTER CATALYZED $3.3 BILLION IN ECONOMIC IMPACT IN THE DOWNTOWN AREAS
OF LITTLE ROCK AND NORTH LITTLE ROCK.
FORM 990 PART III LINE 4C
THE CLINTON GIUSTRA ENTERPRISE PARTNERSHIP (CGEP) BUILDS SOCIAL
BUSINESSES TO GENERATE SOCIAL IMPACT AND FINANCIAL RETURNS BY
ADDRESSING MARKET GAPS IN DEVELOPING COUNTRIES' SUPPLY OR DISTRIBUTION
CHAINS. CGEP WORKS WITH SMALLHOLDER FARMERS, FISHERS, WOMEN
ENTREPRENEURS, AND YOUTH TO IMPROVE THEIR LIVELIHOODS BY PROVIDING THE
TOOLS THEY NEED FROM TRAINING AND FINANCING TO TECHNOLOGY AND
INNOVATION AND BRINGING THEM INTO MARKETS WHERE THEY CAN PROSPER. CGEP
INCORPORATES INDIVIDUALS INTO ONE OF THREE MARKET-DRIVEN MODELS SUPPLY
CHAIN BUSINESSES, INCLUSIVE DISTRIBUTION BUSINESSES, AND VOCATIONAL
TRAINING CENTER BUSINESSES. THROUGH THESE MODELS, CGEP SEEKS TO HELP
PEOPLE WORK THEMSELVES OUT OF POVERTY. IN 2016, CGEP EXPANDED ITS WORK
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
CONNECTING SMALLHOLDER FARMERS WITH HIGH-VALUE MARKETS.
50 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016) Page 2 Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number
FOUNDATION 31-1580204
FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:
THE CLINTON DEVELOPMENT INITIATIVE (CDI) DEVELOPS AND OPERATES
AGRIBUSINESS PROJECTS THAT EMPOWER SMALLHOLDER FARMERS TO INCREASE
THEIR ECONOMIC POTENTIAL. IN MALAWI, TANZANIA, AND RWANDA, CDI PERFORMS
OUTREACH TO SMALLHOLDER FARMERS TO INCREASE ACCESS AND HELP THEM TO
PARTICIPATE EQUITABLY IN LOCAL MARKETS. CDI'S MODEL PUTS FARMERS FIRST
BY PROVIDING THEM TRAINING, AS WELL AS INCREASING THEIR ACCESS TO
INPUTS TO IMPROVE THEIR CROP YIELDS AND INCREASE THEIR INCOMES. IN
2016, CDI GREW ITS SMALLHOLDER FARMER OUTREACH IN RWANDA, MALAWI, AND
TANZANIA, AND IS NOW HELPING MORE THAN 150,000 FARMERS THROUGH TRAINING
AND BY PROVIDING SEEDS AND FERTILIZER TO INCREASE THEIR YIELDS AND
INCOMES. CDI ALSO HELPED FARMERS IN MALAWI FIND NEW MARKETS IN EUROPE
FOR THEIR GROUNDNUTS AND OPENED THE FIRST OF THREE PLANNED HEALTH
CLINICS ON OUR ANCHOR FARM IN MALAWI . THE CLINIC PROVIDES PRIMARY
HEALTH CARE SERVICES AND DISEASE PREVENTION, AND SAW TENS OF THOUSANDS
OF PATIENTS BETWEEN APRIL AND DECEMBER OF 2016.
THE CLINTON CLIMATE INITIATIVE (CCI) COLLABORATES WITH GOVERNMENTS AND
PARTNERS TO INCREASE THE RESILIENCY OF COMMUNITIES FACING CLIMATE
CHANGE BY CREATING AND IMPLEMENTING REPLICABLE AND SUSTAINABLE MODELS
THAT FOSTER CROSS-SECTOR COLLABORATIONS. CCI 'S APPROACH ADDRESSES MAJOR
SOURCES OF GREENHOUSE GAS EMISSIONS BY BRINGING TOGETHER RELEVANT
PARTNERS, WHILE ALSO SAVING MONEY FOR INDIVIDUALS AND GOVERNMENTS AND
GROWING ECONOMIES. IN 2016, CCI CONTINUED ASSISTING WITH THE
DEVELOPMENT OF RENEWABLE ENERGY PROJECTS ACROSS THE CARIBBEAN. FOR
EXAMPLE, A 3 MW SOLAR PROJECT AND A 30 MW GEOTHERMAL PROJECT IN SAINT
LUCIA THAT, WHEN FULLY CONSTRUCTED AND OPERATIONAL, ARE EXPECTED TO
632212 08-25-16 Schedule O (Form 990 or 990-EZ) (2016) 51
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:
THE CLINTON DEVELOPMENT INITIATIVE (CDI) DEVELOPS AND OPERATES
AGRIBUSINESS PROJECTS THAT EMPOWER SMALLHOLDER FARMERS TO INCREASE
THEIR ECONOMIC POTENTIAL. IN MALAWI, TANZANIA, AND RWANDA, CDI PERFORMS
OUTREACH TO SMALLHOLDER FARMERS TO INCREASE ACCESS AND HELP THEM TO
PARTICIPATE EQUITABLY IN LOCAL MARKETS. CDI'S MODEL PUTS FARMERS FIRST
BY PROVIDING THEM TRAINING, AS WELL AS INCREASING THEIR ACCESS TO
INPUTS TO IMPROVE THEIR CROP YIELDS AND INCREASE THEIR INCOMES. IN
2016, CDI GREW ITS SMALLHOLDER FARMER OUTREACH IN RWANDA, MALAWI, AND
TANZANIA, AND IS NOW HELPING MORE THAN 150,000 FARMERS THROUGH TRAINING
AND BY PROVIDING SEEDS AND FERTILIZER TO INCREASE THEIR YIELDS AND
INCOMES. CDI ALSO HELPED FARMERS IN MALAWI FIND NEW MARKETS IN EUROPE
FOR THEIR GROUNDNUTS AND OPENED THE FIRST OF THREE PLANNED HEALTH
CLINICS ON OUR ANCHOR FARM IN MALAWI. THE CLINIC PROVIDES PRIMARY
HEALTH CARE SERVICES AND DISEASE PREVENTION, AND SAW TENS OF THOUSANDS
OF PATIENTS BETWEEN APRIL AND DECEMBER OF 2016.
THE CLINTON CLIMATE INITIATIVE (CCI) COLLABORATES WITH GOVERNMENTS AND
PARTNERS TO INCREASE THE RESILIENCY OF COMMUNITIES FACING CLIMATE
CHANGE BY CREATING AND IMPLEMENTING REPLICABLE AND SUSTAINABLE MODELS
THAT FOSTER CROSS-SECTOR COLLABORATIONS. CCI'S APPROACH ADDRESSES MAJOR
SOURCES OF GREENHOUSE GAS EMISSIONS BY BRINGING TOGETHER RELEVANT
PARTNERS, WHILE ALSO SAVING MONEY FOR INDIVIDUALS AND GOVERNMENTS AND
GROWING ECONOMIES. IN 2016, CCI CONTINUED ASSISTING WITH THE
DEVELOPMENT OF RENEWABLE ENERGY PROJECTS ACROSS THE CARIBBEAN. FOR
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
EXAMPLE, A 3 MW SOLAR PROJECT AND A 30 MW GEOTHERMAL PROJECT IN SAINT
LUCIA THAT, WHEN FULLY CONSTRUCTED AND OPERATIONAL, ARE EXPECTED TO
51 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016)
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
BRING CLEAN POWER TO HALF OF THE COUNTRY'S 60,000 HOUSEHOLDS. IN ORDER
TO AMPLIFY THE LONG-TERM IMPACT OF THESE EFFORTS, IN FEBRUARY 2016 CCI
LAUNCHED A NEW WOMEN IN RENEWABLE ENERGY (WIRE) NETWORK SO THAT MORE
WOMEN ARE EMPOWERED TO BECOME PART OF THE ENERGY SOLUTIONS IN THEIR
COMMUNITIES AND TO REAFFIRM OUR COMMITMENT TO THE FULL PARTICIPATION
OF GIRLS AND WOMEN.
THE CLINTON FOUNDATION HAS BEEN ACTIVELY ENGAGED IN HAITI SINCE 2009,
FOCUSING ON ECONOMIC DIVERSIFICATION, PRIVATE SECTOR INVESTMENT, AND
JOB CREATION IN ORDER TO CREATE LONG-TERM, SUSTAINABLE ECONOMIC
DEVELOPMENT. SINCE 2010, THE CLINTON FOUNDATION HAS RAISED A TOTAL OF
MORE THAN $30 MILLION FOR HAITI, INCLUDING RELIEF FUNDS AS WELL AS
FUNDS FOCUSED ON SUSTAINABLE DEVELOPMENT, EDUCATION, AND CAPACITY
BUILDING PROGRAMS. THE CLINTON FOUNDATION CONCENTRATES ON CREATING
SUSTAINABLE ECONOMIC GROWTH IN FIVE PRIORITY SECTORS INCLUDING ENERGY,
TOURISM, AGRICULTURE, ENVIRONMENT, AND ARTISANS/MANUFACTURING, WHERE IT
WORKS TO DEVELOP NEW MARKETS FOR HAITIAN PRODUCTS; TO ENGAGE
INTERNATIONAL COMPANIES AND INVESTORS; AND TO STRENGTHEN LOCAL
ORGANIZATIONS, ENTREPRENEURS, AND BUSINESSES. IN 2016, THE FOUNDATION'S
WORK IN HAITI SUPPORTED INCREASED PRODUCTION OF IMPORTANT CROPS SUCH AS
PEANUTS HELPING TO IMPROVE INCOMES FOR MORE THAN 3,000 FARMERS. IN THE
AFTERMATH OF HURRICANE MATTHEW WHICH DEVASTATED THE COUNTRY 'S SOUTHERN
REGION AND LEFT AN ESTIMATED 800,000 PEOPLE IN URGENT NEED OF EMERGENCY
RELIEF MEMBERS OF THE CGI HAITI ACTION NETWORK PROVIDED MORE THAN $15
MILLION WORTH OF EMERGENCY SUPPLIES, EQUIPMENT, AND SERVICES TO HELP
SUPPORT THE RECOVERY EFFORT.
THE CLINTON HEALTH MATTERS INITIATIVE (CHMI) WORKS TO IMPROVE THE 632212 08-25-16
Page 2
Employer identification number 31-1580204
Schedule O (Form 990 or 990-EZ) (2016) 52
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
BRING CLEAN POWER TO HALF OF THE COUNTRY'S 60,000 HOUSEHOLDS. IN ORDER
TO AMPLIFY THE LONG-TERM IMPACT OF THESE EFFORTS, IN FEBRUARY 2016 CCI
LAUNCHED A NEW WOMEN IN RENEWABLE ENERGY (WIRE) NETWORK SO THAT MORE
WOMEN ARE EMPOWERED TO BECOME PART OF THE ENERGY SOLUTIONS IN THEIR
COMMUNITIES AND TO REAFFIRM OUR COMMITMENT TO THE FULL PARTICIPATION
OF GIRLS AND WOMEN.
THE CLINTON FOUNDATION HAS BEEN ACTIVELY ENGAGED IN HAITI SINCE 2009,
FOCUSING ON ECONOMIC DIVERSIFICATION, PRIVATE SECTOR INVESTMENT, AND
JOB CREATION IN ORDER TO CREATE LONG-TERM, SUSTAINABLE ECONOMIC
DEVELOPMENT. SINCE 2010, THE CLINTON FOUNDATION HAS RAISED A TOTAL OF
MORE THAN $30 MILLION FOR HAITI, INCLUDING RELIEF FUNDS AS WELL AS
FUNDS FOCUSED ON SUSTAINABLE DEVELOPMENT, EDUCATION, AND CAPACITY
BUILDING PROGRAMS. THE CLINTON FOUNDATION CONCENTRATES ON CREATING
SUSTAINABLE ECONOMIC GROWTH IN FIVE PRIORITY SECTORS INCLUDING ENERGY,
TOURISM, AGRICULTURE, ENVIRONMENT, AND ARTISANS/MANUFACTURING, WHERE IT
WORKS TO DEVELOP NEW MARKETS FOR HAITIAN PRODUCTS; TO ENGAGE
INTERNATIONAL COMPANIES AND INVESTORS; AND TO STRENGTHEN LOCAL
ORGANIZATIONS, ENTREPRENEURS, AND BUSINESSES. IN 2016, THE FOUNDATION'S
WORK IN HAITI SUPPORTED INCREASED PRODUCTION OF IMPORTANT CROPS SUCH AS
PEANUTS HELPING TO IMPROVE INCOMES FOR MORE THAN 3,000 FARMERS. IN THE
AFTERMATH OF HURRICANE MATTHEW WHICH DEVASTATED THE COUNTRY'S SOUTHERN
REGION AND LEFT AN ESTIMATED 800,000 PEOPLE IN URGENT NEED OF EMERGENCY
RELIEF MEMBERS OF THE CGI HAITI ACTION NETWORK PROVIDED MORE THAN $15
MILLION WORTH OF EMERGENCY SUPPLIES, EQUIPMENT, AND SERVICES TO HELP
SUPPORT THE RECOVERY EFFORT.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
THE CLINTON HEALTH MATTERS INITIATIVE (CHMI) WORKS TO IMPROVE THE
52 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016) Page 2 Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number
FOUNDATION 31-1580204
HEALTH AND WELL-BEING OF PEOPLE ACROSS THE U.S. BY ACTIVATING
INDIVIDUALS, COMMUNITIES, AND ORGANIZATIONS TO MAKE MEANINGFUL
CONTRIBUTIONS TO THE HEALTH OF OTHERS . BY BUILDING STRATEGIC
PARTNERSHIPS AND WORKING ACROSS SECTORS, CHMI WORKS TO REDUCE THE
PREVALENCE OF PREVENTABLE HEALTH OUTCOMES AND CLOSE HEALTH INEQUITY AND
DISPARITY GAPS BY IMPROVING ACCESS TO KEY CONTRIBUTORS TO HEALTH FOR
ALL PEOPLE. IN 2016, CHMI NEGOTIATED A AGREEMENT WITH
ADAPT PHARMA TO PROVIDE THE FIRST NASAL SPRAY VERSION OF NALOXONE, A
DRUG THAT CAN REVERSE OPIOID OVERDOSES, TO ALL U.S. HIGH SCHOOLS FREE
OF CHARGE. AS OF THE END OF 2016, THE DISTRIBUTIONS HAVE ALREADY BEGUN
IN THIRTY-TWO STATES ACROSS THE COUNTRY.
NO CEILINGS: THE FULL PARTICIPATION PROJECT IS AN INITIATIVE OF THE
CLINTON FOUNDATION WHICH AIMS TO ADVANCE THE FULL PARTICIPATION OF
GIRLS AND WOMEN AROUND THE WORLD . THROUGH A DATA-DRIVEN ANALYSIS ON
GENDER EQUALITY, AN IN-DEPTH CONVERSATION SERIES, INNOVATIVE
PARTNERSHIPS, AND CGI COMMITMENTS, NO CEILINGS BUILDS AN EVIDENCE-BASED
CASE TO CHART THE PATH FORWARD FOR THE FULL PARTICIPATION OF GIRLS AND
WOMEN IN THE 21ST CENTURY. IN 2016, NO CEILINGS TOGETHER WITH VITAL
VOICES GLOBAL PARTNERSHIP AND WECONNECT INTERNATIONAL LAUNCHED A NEW
COALITION OF 30 PARTNERS FROM THE PUBLIC AND PRIVATE SECTORS THAT SEEKS
TO INCREASE WOMEN 'S ECONOMIC PARTICIPATION, ADDRESS VIOLENCE AGAINST
GIRLS AND WOMEN, AND PROMOTE WOMEN 'S LEADERSHIP. THE GROUP ANNOUNCED 24
NEW COMMITMENTS TO ACTION AT THE 2016 CLINTON GLOBAL INITIATIVE ANNUAL
MEETING, WHICH WILL INVEST MORE THAN $70 MILLION TO HELP NEARLY 900,000
PEOPLE ACROSS SIX CONTINENTS TO PROMOTE GENDER EQUALITY.
TOO SMALL TO FAIL, A JOINT INITIATIVE OF THE CLINTON FOUNDATION AND THE 632212 08-25-16 Schedule O (Form 990 or 990-EZ) (2016)
53 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
HEALTH AND WELL-BEING OF PEOPLE ACROSS THE U.S. BY ACTIVATING
INDIVIDUALS, COMMUNITIES, AND ORGANIZATIONS TO MAKE MEANINGFUL
CONTRIBUTIONS TO THE HEALTH OF OTHERS. BY BUILDING STRATEGIC
PARTNERSHIPS AND WORKING ACROSS SECTORS, CHMI WORKS TO REDUCE THE
PREVALENCE OF PREVENTABLE HEALTH OUTCOMES AND CLOSE HEALTH INEQUITY AND
DISPARITY GAPS BY IMPROVING ACCESS TO KEY CONTRIBUTORS TO HEALTH FOR
ALL PEOPLE. IN 2016, CHMI NEGOTIATED A GROUNDBREAKING AGREEMENT WITH
ADAPT PHARMA TO PROVIDE THE FIRST NASAL SPRAY VERSION OF NALOXONE, A
DRUG THAT CAN REVERSE OPIOID OVERDOSES, TO ALL U.S. HIGH SCHOOLS FREE
OF CHARGE. AS OF THE END OF 2016, THE DISTRIBUTIONS HAVE ALREADY BEGUN
IN THIRTY-TWO STATES ACROSS THE COUNTRY.
NO CEILINGS: THE FULL PARTICIPATION PROJECT IS AN INITIATIVE OF THE
CLINTON FOUNDATION WHICH AIMS TO ADVANCE THE FULL PARTICIPATION OF
GIRLS AND WOMEN AROUND THE WORLD. THROUGH A DATA-DRIVEN ANALYSIS ON
GENDER EQUALITY, AN IN-DEPTH CONVERSATION SERIES, INNOVATIVE
PARTNERSHIPS, AND CGI COMMITMENTS, NO CEILINGS BUILDS AN EVIDENCE-BASED
CASE TO CHART THE PATH FORWARD FOR THE FULL PARTICIPATION OF GIRLS AND
WOMEN IN THE 21ST CENTURY. IN 2016, NO CEILINGS TOGETHER WITH VITAL
VOICES GLOBAL PARTNERSHIP AND WECONNECT INTERNATIONAL LAUNCHED A NEW
COALITION OF 30 PARTNERS FROM THE PUBLIC AND PRIVATE SECTORS THAT SEEKS
TO INCREASE WOMEN'S ECONOMIC PARTICIPATION, ADDRESS VIOLENCE AGAINST
GIRLS AND WOMEN, AND PROMOTE WOMEN'S LEADERSHIP. THE GROUP ANNOUNCED 24
NEW COMMITMENTS TO ACTION AT THE 2016 CLINTON GLOBAL INITIATIVE ANNUAL
MEETING, WHICH WILL INVEST MORE THAN $70 MILLION TO HELP NEARLY 900,000
PEOPLE ACROSS SIX CONTINENTS TO PROMOTE GENDER EQUALITY.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
TOO SMALL TO FAIL, A JOINT INITIATIVE OF THE CLINTON FOUNDATION AND THE
53 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016)
Name of the organization BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
OPPORTUNITY INSTITUTE, IS LEADING A PUBLIC AWARENESS AND ACTION
CAMPAIGN TO PROMOTE THE IMPORTANCE OF EARLY BRAIN AND LANGUAGE
DEVELOPMENT AND TO SUPPORT PARENTS WITH TOOLS TO TALK, READ, AND SING
WITH THEIR YOUNG CHILDREN FROM BIRTH. TODAY, ALMOST 60 PERCENT OF
CHILDREN IN THE UNITED STATES START KINDERGARTEN UNPREPARED, LAGGING
BEHIND THEIR PEERS IN CRITICAL LANGUAGE SKILLS. THROUGH PARTNERSHIPS
WITH PEDIATRICIANS, HOSPITALS, FAITH-BASED LEADERS, COMMUNITY BASED
ORGANIZATIONS, BUSINESSES, ENTERTAINMENT INDUSTRY LEADERS, AND OTHERS,
TOO SMALL TO FAIL IS MEETING PARENTS WHERE THEY ARE TO HELP THEM
PREPARE THEIR CHILDREN FOR SUCCESS IN SCHOOL AND BEYOND. WHETHER AT THE
PEDIATRICIAN'S OFFICE OR THE PLAYGROUND, TOO SMALL TO FAIL AIMS TO MAKE
SMALL MOMENTS BIG BY CREATING OPPORTUNITIES FOR MEANINGFUL INTERACTIONS
ANYTIME, ANYWHERE. IN 2016, TOO SMALL TO FAIL LAUNCHED A NEW EFFORT TO
DISTRIBUTE BOOKS TO UNDERSERVED FAMILIES THROUGH DIAPER BANKS, AND
OPENED 21 'TALKING IS TEACHING' THEMED PLAYGROUNDS AROUND THE COUNTRY
THAT INTEGRATE LEARNING WITH PLAY USING CONVERSATIONAL PROMPTS THAT
ENCOURAGE PARENTS TO TALK, READ, AND SING WITH THEIR CHILDREN. THROUGH
2016, TOO SMALL TO FAIL DISTRIBUTED MORE THAN 839,000 BOOKS TO
UNDERSERVED COMMUNITIES IN THE UNITED STATES.
THE ALLIANCE FOR A HEALTHIER GENERATION (ALLIANCE), AN AFFILIATED
ENTITY, FOUNDED BY THE CLINTON FOUNDATION AND THE AMERICAN HEART
ASSOCIATION, EMPOWERS KIDS TO DEVELOP LIFELONG, HEALTHY HABITS BY
ENSURING THE ENVIRONMENTS THAT SURROUND THEM PROVIDE AND PROMOTE GOOD
HEALTH. IN 2016, THE ALLIANCE CONTINUED ITS EFFORTS TO EMPOWER KIDS TO
DEVELOP LIFELONG HEALTHY HABITS THROUGH ITS WORK IN SCHOOLS, JUVENILE
JUSTICE FACILITIES, AND OUT-OF-SCHOOL TIME SITES REACHING MORE THAN 21
MILLION YOUNG PEOPLE IN NEARLY 35,000 SCHOOLS AND MORE THAN 2,600 632212 08-25-16
Page 2
Employer identification number 31-1580204
Schedule O (Form 990 or 990-EZ) (2016) 54
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
OPPORTUNITY INSTITUTE, IS LEADING A PUBLIC AWARENESS AND ACTION
CAMPAIGN TO PROMOTE THE IMPORTANCE OF EARLY BRAIN AND LANGUAGE
DEVELOPMENT AND TO SUPPORT PARENTS WITH TOOLS TO TALK, READ, AND SING
WITH THEIR YOUNG CHILDREN FROM BIRTH. TODAY, ALMOST 60 PERCENT OF
CHILDREN IN THE UNITED STATES START KINDERGARTEN UNPREPARED, LAGGING
BEHIND THEIR PEERS IN CRITICAL LANGUAGE SKILLS. THROUGH PARTNERSHIPS
WITH PEDIATRICIANS, HOSPITALS, FAITH-BASED LEADERS, COMMUNITY BASED
ORGANIZATIONS, BUSINESSES, ENTERTAINMENT INDUSTRY LEADERS, AND OTHERS,
TOO SMALL TO FAIL IS MEETING PARENTS WHERE THEY ARE TO HELP THEM
PREPARE THEIR CHILDREN FOR SUCCESS IN SCHOOL AND BEYOND. WHETHER AT THE
PEDIATRICIAN'S OFFICE OR THE PLAYGROUND, TOO SMALL TO FAIL AIMS TO MAKE
SMALL MOMENTS BIG BY CREATING OPPORTUNITIES FOR MEANINGFUL INTERACTIONS
ANYTIME, ANYWHERE. IN 2016, TOO SMALL TO FAIL LAUNCHED A NEW EFFORT TO
DISTRIBUTE BOOKS TO UNDERSERVED FAMILIES THROUGH DIAPER BANKS, AND
OPENED 21 "TALKING IS TEACHING" THEMED PLAYGROUNDS AROUND THE COUNTRY
THAT INTEGRATE LEARNING WITH PLAY USING CONVERSATIONAL PROMPTS THAT
ENCOURAGE PARENTS TO TALK, READ, AND SING WITH THEIR CHILDREN. THROUGH
2016, TOO SMALL TO FAIL DISTRIBUTED MORE THAN 839,000 BOOKS TO
UNDERSERVED COMMUNITIES IN THE UNITED STATES.
THE ALLIANCE FOR A HEALTHIER GENERATION (ALLIANCE), AN AFFILIATED
ENTITY, FOUNDED BY THE CLINTON FOUNDATION AND THE AMERICAN HEART
ASSOCIATION, EMPOWERS KIDS TO DEVELOP LIFELONG, HEALTHY HABITS BY
ENSURING THE ENVIRONMENTS THAT SURROUND THEM PROVIDE AND PROMOTE GOOD
HEALTH. IN 2016, THE ALLIANCE CONTINUED ITS EFFORTS TO EMPOWER KIDS TO
DEVELOP LIFELONG HEALTHY HABITS THROUGH ITS WORK IN SCHOOLS, JUVENILE
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
JUSTICE FACILITIES, AND OUT-OF-SCHOOL TIME SITES REACHING MORE THAN 21
MILLION YOUNG PEOPLE IN NEARLY 35,000 SCHOOLS AND MORE THAN 2,600
54 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016) Page 2 Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number
FOUNDATION 31-1580204
OUT-OF-SCHOOL TIME SITES.
FORM 990, PART III, LINE 4C TOTAL OTHER PROGRAM SERVICES:
EXPENSES $ 23,986,884. INCL GRANTS OF $ 2,732,659. REVENUE $ -143,224.
FORM 990, PART V, LINE 4B, LIST OF FOREIGN COUNTRIES:
AUSTRALIA, COLOMBIA, EL SALVADOR, HAITI,
INDIA, KENYA, MALAWI, PERU,
RWANDA, TANZANIA
FORM 990, PART VI, SECTION A, LINE 1:
THE BOARD OF DIRECTORS PROVIDES GOVERNANCE AND OVERSIGHT FOR THE
FOUNDATION'S AFFAIRS. THE FOUNDATION'S BYLAWS ESTABLISH TWO CLASSES OF
DIRECTORS: CLASS A AND CLASS B . ACTIONS BY THE BOARD REQUIRE THE SUPPORT OF
A MAJORITY OF DIRECTORS ELIGIBLE TO VOTE, INCLUDING AT LEAST ONE CLASS A
DIRECTOR. THE CLASS A DIRECTORS CONSIST OF WILLIAM J. CLINTON AND CHELSEA
V . CLINTON. THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS ARE CLASS B
DIRECTORS. THERE IS ALSO AN EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE
COMMITTEE CONSISTS OF THE CLASS A DIRECTORS AND AN ADDITIONAL MEMBER OF THE
BOARD ELECTED BY THE CLASS A DIRECTORS . THE EXECUTIVE COMMITTEE MAY ACT FOR
THE BOARD BETWEEN MEETINGS, AND RESERVES THE EXCLUSIVE AUTHORITY TO REVIEW
AND APPROVE DECISIONS RELATED TO THE USE OF THE CLINTON NAME AND THE
RENAMING OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 2:
WILLIAM JEFFERSON CLINTON AND CHELSEA V . CLINTON HAVE A FAMILY
RELATIONSHIP.
632212 08-25-16 Schedule O (Form 990 or 990-EZ) (2016) 55
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
OUT-OF-SCHOOL TIME SITES.
FORM 990, PART III, LINE 4C TOTAL OTHER PROGRAM SERVICES:
EXPENSES $ 23,986,884. INCL GRANTS OF $ 2,732,659. REVENUE $ -143,224.
FORM 990, PART V, LINE 4B, LIST OF FOREIGN COUNTRIES:
AUSTRALIA, COLOMBIA, EL SALVADOR, HAITI,
INDIA, KENYA, MALAWI, PERU,
RWANDA, TANZANIA
FORM 990, PART VI, SECTION A, LINE 1:
THE BOARD OF DIRECTORS PROVIDES GOVERNANCE AND OVERSIGHT FOR THE
FOUNDATION'S AFFAIRS. THE FOUNDATION'S BYLAWS ESTABLISH TWO CLASSES OF
DIRECTORS: CLASS A AND CLASS B. ACTIONS BY THE BOARD REQUIRE THE SUPPORT OF
A MAJORITY OF DIRECTORS ELIGIBLE TO VOTE, INCLUDING AT LEAST ONE CLASS A
DIRECTOR. THE CLASS A DIRECTORS CONSIST OF WILLIAM J. CLINTON AND CHELSEA
V. CLINTON. THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS ARE CLASS B
DIRECTORS. THERE IS ALSO AN EXECUTIVE COMMITTEE OF THE BOARD. THE EXECUTIVE
COMMITTEE CONSISTS OF THE CLASS A DIRECTORS AND AN ADDITIONAL MEMBER OF THE
BOARD ELECTED BY THE CLASS A DIRECTORS. THE EXECUTIVE COMMITTEE MAY ACT FOR
THE BOARD BETWEEN MEETINGS, AND RESERVES THE EXCLUSIVE AUTHORITY TO REVIEW
AND APPROVE DECISIONS RELATED TO THE USE OF THE CLINTON NAME AND THE
RENAMING OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 2:
WILLIAM JEFFERSON CLINTON AND CHELSEA V. CLINTON HAVE A FAMILY
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
RELATIONSHIP.
55 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016) Page 2 Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number
FOUNDATION 31-1580204
FORM 990 V, LINE 2A:
THE NUMBER OF EMPLOYEES INCLUDES EMPLOYEES OF THE CLINTON GLOBAL INITIATIVE
EIN 27-1551550 WHICH WAS MERGED INTO THE BILL, HILLARY & CHELSEA CLINTON
FOUNDATION IN 2013.
FORM 990, PART VI, SECTION B, LINE 11B:
A COPY OF THE ORGANIZATION'S FORM 990 IS CIRCULATED TO THE BOARD, AMONG THE
VARIOUS OFFICERS AND AMONG THE VARIOUS INITIATIVE HEADS FOR REVIEW PRIOR TO
FILING.
FORM 990, PART VI, SECTION B, LINE 12C:
THE ORGANIZATION MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY
BY REQUIRING DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE POTENTIAL
CONFLICTS ANNUALLY. THE ANNUAL DISCLOSURES ARE REVIEWED BY COUNSEL AND IF
ANY POTENTIAL CONFLICT EXISTS, IT WOULD BE EXAMINED AND APPROPRIATE ACTION
WOULD BE TAKEN.
FORM 990, PART VI, SECTION B, LINE 15B:
THE TOP MANAGEMENT OFFICIAL WAS UNPAID DURING 2016, THEREFORE, THERE WAS NO
REVIEW OF COMPENSATION AND QUESTION ON PART VI, 15A IS ANSWERED NO.
THE ORGANIZATION PARTICIPATES IN AN ANNUAL COMPENSATION STUDY THAT REVIEWS
THREE SURVEYS TO DETERMINE THE REASONABLENESS OF STAFF COMPENSATION
INCLUDING TOP MANAGEMENT. THE ORGANIZATION ALSO UTILIZES AN INDEPENDENT
COMPENSATION CONSULTANT. SALARIES ARE APPROVED ANNUALLY BY THE INDEPENDENT
MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 17, LIST OF STATES RECEIVING COPY OF FORM 990:
AK,AL,AR, CA,CT,DC,FL,GA, HI, IL,KS,KY, MD,MA,MI, M N,MS,NH,NJ,NM,NY,NC,ND, OK, OR 632212 08-25-16 Schedule O (Form 990 or 990-EZ) (2016)
56 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
FORM 990 V, LINE 2A:
THE NUMBER OF EMPLOYEES INCLUDES EMPLOYEES OF THE CLINTON GLOBAL INITIATIVE
EIN 27-1551550 WHICH WAS MERGED INTO THE BILL, HILLARY & CHELSEA CLINTON
FOUNDATION IN 2013.
FORM 990, PART VI, SECTION B, LINE 11B:
A COPY OF THE ORGANIZATION'S FORM 990 IS CIRCULATED TO THE BOARD, AMONG THE
VARIOUS OFFICERS AND AMONG THE VARIOUS INITIATIVE HEADS FOR REVIEW PRIOR TO
FILING.
FORM 990, PART VI, SECTION B, LINE 12C:
THE ORGANIZATION MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY
BY REQUIRING DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE POTENTIAL
CONFLICTS ANNUALLY. THE ANNUAL DISCLOSURES ARE REVIEWED BY COUNSEL AND IF
ANY POTENTIAL CONFLICT EXISTS, IT WOULD BE EXAMINED AND APPROPRIATE ACTION
WOULD BE TAKEN.
FORM 990, PART VI, SECTION B, LINE 15B:
THE TOP MANAGEMENT OFFICIAL WAS UNPAID DURING 2016, THEREFORE, THERE WAS NO
REVIEW OF COMPENSATION AND QUESTION ON PART VI, 15A IS ANSWERED NO.
THE ORGANIZATION PARTICIPATES IN AN ANNUAL COMPENSATION STUDY THAT REVIEWS
THREE SURVEYS TO DETERMINE THE REASONABLENESS OF STAFF COMPENSATION
INCLUDING TOP MANAGEMENT. THE ORGANIZATION ALSO UTILIZES AN INDEPENDENT
COMPENSATION CONSULTANT. SALARIES ARE APPROVED ANNUALLY BY THE INDEPENDENT
MEMBERS OF THE BOARD OF DIRECTORS.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
FORM 990, PART VI, LINE 17, LIST OF STATES RECEIVING COPY OF FORM 990:
AK,AL,AR,CA,CT,DC,FL,GA,HI,IL,KS,KY,MD,MA,MI,MN,MS,NH,NJ,NM,NY,NC,ND,OK,OR
56 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule O (Form 990 or 990-EZ) (2016) Page 2 Name of the organization BILL, HILLARY & CHELSEA CLINTON Employer identification number
FOUNDATION 31-1580204
PA,RI,SC,TN,VA,WV,WI
FORM 990, PART VI, SECTION C, LINE 19:
THE ORGANIZATION MAKES ITS AUDITED FINANCIAL STATEMENTS AND ANNUAL REPORT
AVAILABLE ON ITS WEBSITE. ALL OTHER GOVERNING DOCUMENTS ARE AVAILABLE UPON
REQUEST.
FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS:
PROVISION FOR UNCOLLECTIBLE PLEDGE -7,634,797.
VOIDED CHECKS PREVIOUS YEAR 3,246.
PRIOR YEAR REVENUE ADJUSTMENT -160,300.
CONTRIBUTION REFUND PRIOR YEAR -43,000.
TOTAL TO FORM 990, PART XI, LINE 9 -7,834,851.
FORM 990 XII LINE 2C:
THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE
AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT.
632212 08-25-16 Schedule O (Form 990 or 990-EZ) (2016) 57
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organization
PA,RI,SC,TN,VA,WV,WI
FORM 990, PART VI, SECTION C, LINE 19:
THE ORGANIZATION MAKES ITS AUDITED FINANCIAL STATEMENTS AND ANNUAL REPORT
AVAILABLE ON ITS WEBSITE. ALL OTHER GOVERNING DOCUMENTS ARE AVAILABLE UPON
REQUEST.
FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS:
PROVISION FOR UNCOLLECTIBLE PLEDGE -7,634,797.
VOIDED CHECKS PREVIOUS YEAR 3,246.
PRIOR YEAR REVENUE ADJUSTMENT -160,300.
CONTRIBUTION REFUND PRIOR YEAR -43,000.
TOTAL TO FORM 990, PART XI, LINE 9 -7,834,851.
FORM 990 XII LINE 2C:
THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF THE
AUDIT AS WELL AS THE SELECTION OF THE INDEPENDENT ACCOUNTANT.
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
57 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
(d) (e) Total income End-of-year assets
484,658. 0.
0. 0.
(f) Direct controlling
entity
, HILLARY & CHELSEA
TON FOUNDATION
, HILLARY & CHELSEA
TON FOUNDATION
SCHEDULE R (Form 990)
Department of the Treasury Internal Revenue Service
Name of the organization
Related Organizations and Unrelated Partnerships | Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
| Attach to Form 990.
| Information abo t Sched le R (Form 990) and its instr ctions isat i / f 9 9 0
BILL, HILLARY & CHELSEA CLINTON
FOUNDATION
OMB No. 1545-0047
2016 Open to Public
Inspection
Employer identification number 31-1580 204
Part I Identification of Disregarded Entities. Complete if the organization answered Yes on Form 990, Part IV, line 33.
(a) (b) (c) Name, address, and EIN (if applicable) Primary activity Legal domicile (state or
of disregarded entity foreign country)
WILLIAM J. CLINTON FDN (KENYA) CHAR TRUST
ARGWINGS KOHEK ROAD
NAIROBI, KENYA C F PROGRAMS K ENYA
CLINTON FOUNDATION HONG KONG
16/F TAK SHING HOUSE THEATER L
HONG KONG , HONG KONG C F PROGRAMS H ONG KONG
Identifica t ion of Related Tax-Exempt Organizations. Complete if the organiz a tion answered Yes on Form 990, Par t IV, line 34 because i t had one or more related tax-exemp t P ar t I I organizations during the tax year.
(a) (b) (c) (d) (e) (f) Name, address, and EIN Primary activity Legal domicile (state or Exempt Code Public charity Direct controlling of related organization foreign country) section status (if section entity
501 (c)(3)) ___________________ WILLIAM J CLINTON FOUNDATION UK BILL, HILLARY &
ACRE HOUSE 11-15 C HELSEA CLINTON
LONDON, UNITED KINGDOM F UNDRAISING UNITED KINGDOM F OUNDATION
CLINTON HEALTH ACCESS INITIATIVE - BILL, HILLARY &
27-1414646, 383 DORCHESTER AVE, BOSTON, MA C HELSEA CLINTON
02127 H EALTH ARKANSAS 501(C)(3) L INE 7 F OUNDATION
CLINTON FOUNDATION INSALINGSSTIFTELSE BILL, HILLARY &
BIRGER JARLSGATAN 55 C HELSEA CLINTON
STOCKHOLM, SWEDEN 11145 F UNDRAISING SWEDEN F OUNDATION
(g) Section 5 1 2(b) ( 13)
controlled entity?
Yes No
X
X
X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2016
632161 09-06-16 LHA 58
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Section 512(b)(13)
controlled
entity?
632161 09-06-16
SCHEDULE R(Form 990) Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990. Open to PublicInspection| Information about Schedule R (Form 990) and its instructions is at
Employer identification number
Part I Identification of Disregarded Entities.
(a) (b) (c) (d) (e) (f)
Identification of Related Tax-Exempt Organizations. Part II
(a) (b) (c) (d) (e) (f) (g)
Yes No
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2016
|
|
Name of the organization
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
Name, address, and EIN (if applicable)of disregarded entity
Primary activity Legal domicile (state or
foreign country)
Total income End-of-year assets Direct controllingentity
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exemptorganizations during the tax year.
Name, address, and EINof related organization
Primary activity Legal domicile (state or
foreign country)
Exempt Codesection
Public charitystatus (if section
501(c)(3))
Direct controllingentity
LHA
www.irs.gov/form990.
Related Organizations and Unrelated Partnerships
2016
BILL, HILLARY & CHELSEA CLINTONFOUNDATION
WILLIAM J. CLINTON FDN (KENYA) CHAR TRUST
CLINTON FOUNDATION HONG KONGNAIROBI, KENYA
HONG KONG, HONG KONG
WILLIAM J CLINTON FOUNDATION UK
CLINTON HEALTH ACCESS INITIATIVE -
CLINTON FOUNDATION INSALINGSSTIFTELSE
LONDON, UNITED KINGDOM
ARGWINGS KOHEK ROAD
16/F TAK SHING HOUSE THEATER L
02127
STOCKHOLM, SWEDEN 11145
ACRE HOUSE 11-15
27-1414646, 383 DORCHESTER AVE, BOSTON, MA
BIRGER JARLSGATAN 55
CF PROGRAMS 484,658.
0.CF PROGRAMS
0.
0.
FUNDRAISING
HEALTH
FUNDRAISING
BILL, HILLARY & CHELSEAKENYA
HONG KONG
CLINTON FOUNDATION
BILL, HILLARY & CHELSEA
UNITED KINGDOM
ARKANSAS
SWEDEN
CLINTON FOUNDATION
BILL, HILLARY &
BILL, HILLARY &
BILL, HILLARY &
CHELSEA CLINTONFOUNDATION
CHELSEA CLINTON
31-1580204
FOUNDATION
CHELSEA CLINTONFOUNDATION
501(C)(3) LINE 7
X
X
X
58
BILL, HILLARY & CHELSEA CLINTON
Schedule R(Form 990) 2016 FOUNDATION 31-1580204 Page 2
Part III Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered Yes on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a) I (b) (c) (d) I (e) I (f) I (g) I (h) I (i) I (j) I (k)
Name, address, and EIN Primary activity Legal Direct controlling I Predominant income I Share of total I Share of Disproportionate I Code V-UBI General or Percentage domicile of related organization (state or entity I (related, unrelated, income end-of-year allocations? amount in box
managing ownership
partner? foreign excluded from tax under assets 20 of Schedule I
country) I sections 512-514) I I I Yes I No I K-1 (Form 1065) Ye s No
ACCESO FUND LLC - 27-2075171
1271 AVE OF AMERICAS
NEW YORK, NY 10020
ACCESO OFERTA
LOCAL-PRODUCTORS DE EL SA,
CALLE EL MIRADOR Y 93
AVENIDA, EL SALVADOR
HAITI DEVELOPMENT FUND LLC -
45-3819678, 1271 AVE OF
AMERICAS, NEW YORK, NY 10020
ESTMENT DE N /A
IT & BEG. E L A CCESO FUND
PLY S ALVADO LLC
ESTMENT DE N /A
-1,767,927. 2,466,243
-417,463. 415,460
-9,119. 117,934
N/A I X I 50.00%
N/A I X I 50.00%
N/A I X I 50.00%
Part IV Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered Yes on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a) (b) (c) (d) (e) (f) (g) (h) (i) Section
Name, address, and EIN Primary activity Legal domicile Direct controlling Type of entity Share of total Share of Percentage 512(b)(13)
of related organization (state or entity (C corp, S corp, income end-of-year ownership controlled foreign entity? or trust) assets country)
Yes No ACACIA DEVELOPMENT CO - 81-1675271 B ILL, HILLARY
1271 AVENUE OF AMERICAS & CHELSEA
NEW YORK, NY 10020 INVESTMENT DE C LINTON C CORP 0. 250,100. 100% X
ACCESO CASHEW ENTERPRISE LIMITED
OFFICE NO 201 KOHINOOR PARADISE AROGYA A CCESO
MAHARASHTRA, INDIA C ASHEW PROCESSING INDIA WORLDWIDE FUND C CORP 45,848. 0. 99.99% X
ACCESO OFERTA LOCAL COLOMBIA S.A.S.
(FORMERLY ACCESO BOYACA S.A.S.), CALLE 93A
NO. 14-17 OF. 707, BOGOTA, COLOMBIA SUPPLY OF FOOD STUFF C OLOMBIA F ONDO ACCESO C CORP 0. 0. 50.00% X
ACCESO OFERTA LOCAL PRODUCTOS DEL CARIBE
TERNERA 1 BODEGA 49 F ONDO ACCESO
CARTEGENA, COLOMBIA SUPPLY OF FOOD STUFF C OLOMBIA S AS C CORP -62,150. 830,920. 50.00% X
ACCESO PEANUT ENTERPRISE CORPORATION
11 RUE OGE PETION-VILLE A CCESO FUND
RUE DORZIN PROLONGEE MIRABELAIS, HAITI P EANUT SUPPLY CHAIN H AITI L LC C CORP -2,953. 13,199. 50.00% X 632162 09-06-16 Schedule R (Form 990) 2016
SEE PART VII FOR CONTINUATIONS 59
Disproportionate
allocations?
Legaldomicile(state orforeigncountry)
General ormanagingpartner?
Section512(b)(13)controlled
entity?
Legal domicile(state orforeigncountry)
632162 09-06-16
2
Identification of Related Organizations Taxable as a Partnership. Part III
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
Yes No Yes No
Identification of Related Organizations Taxable as a Corporation or Trust. Part IV
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Yes No
Schedule R (Form 990) 2016
Predominant income(related, unrelated,
excluded from tax undersections 512-514)
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a partnership during the tax year.
Name, address, and EINof related organization
Primary activity Direct controllingentity
Share of totalincome
Share ofend-of-year
assets
Code V-UBIamount in box20 of ScheduleK-1 (Form 1065)
Percentageownership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a corporation or trust during the tax year.
Name, address, and EINof related organization
Primary activity Direct controllingentity
Type of entity(C corp, S corp,
or trust)
Share of totalincome
Share ofend-of-year
assets
Percentageownership
ACCESO OFERTA
1271 AVE OF AMERICASNEW YORK, NY 10020
CALLE EL MIRADOR Y 93
ACCESO FUND LLC - 27-2075171
LOCAL-PRODUCTORS DE EL SA,
HAITI DEVELOPMENT FUND LLC -
AVENIDA, EL SALVADOR
45-3819678, 1271 AVE OFAMERICAS, NEW YORK, NY 10020
ACACIA DEVELOPMENT CO - 81-1675271
ACCESO CASHEW ENTERPRISE LIMITED
ACCESO OFERTA LOCAL COLOMBIA S.A.S.
ACCESO OFERTA LOCAL PRODUCTOS DEL CARIBE
ACCESO PEANUT ENTERPRISE CORPORATION
1271 AVENUE OF AMERICAS
OFFICE NO 201 KOHINOOR PARADISE AROGYA
(FORMERLY ACCESO BOYACA S.A.S.), CALLE 93A
TERNERA 1 BODEGA 49
11 RUE OGE PETION-VILLE
FRUIT & BEG.
DE
DE
ACCESO FUND
DE
BILL, HILLARY
RELATED
RELATED
RELATED
C CORP
C CORP
C CORP
C CORP
C CORP
NEW YORK, NY 10020
MAHARASHTRA, INDIA
-1,767,927.
-417,463.
-9,119.
NO. 14-17 OF. 707, BOGOTA, COLOMBIA
CARTEGENA, COLOMBIA
RUE DORZIN PROLONGEE MIRABELAIS, HAITI
0.
45,848.
0.
-62,150.
-2,953.
INVESTMENT
2,466,243.
415,460.
117,934.
CASHEW PROCESSING
250,100.
0.
0.
830,920.
13,199.
SUPPLY OF FOOD STUFF
SUPPLY OF FOOD STUFF
PEANUT SUPPLY CHAIN
100%
99.99%
50.00%
50.00%
50.00%
& CHELSEACLINTON
ACCESOWORLDWIDE FUND
X
X
X
FONDO ACCESO
FONDO ACCESOSAS
X
X
X
ACCESO FUNDLLC
INVESTMENT
SUPPLY
INVESTMENT
N/A
LLC
N/A
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
N/A
N/A
N/A
EL SALVADO
INDIA
COLOMBIA
COLOMBIA
HAITI
50.00%
50.00%
50.00%
SEE PART VII FOR CONTINUATIONS
X
X
X
X
X
59
BILL, HILLARY & CHELSEA CLINTON
Schedule R (Form 990) FOUNDATION 31-1580204
I Part IV I Continuation of Identification of Related Organizations Taxable as a Corporation or Trust
(a) (b) (c) (d) (e) (f) (g) (h) (i)Section
Name, address, and EIN Primary activity Legal domicile Direct controlling Type of entity Share of total Share of Percentage 512(b)(13)
of related organization (state or entity (C corp, S corp, income end-of-year ownership controlled foreign entity? or trust) assets country)
Y e s N o ACCESO WORLDWIDE FUND INC. - 46-4160920 BILL, HILLARY
1271 AVENUE OF AMERICAS & CHELSEA
NEW YORK, NY 10020 INVESTMENT DE CLINTON C CORP 144,689. 662,462. 100% X
CHAKIPI ACCESO SA PERU
CALLE CASCANUECES MZ M2 ACCESO FUND
LOTE 4 LIMA, PERU DISTRIBUTION OF GOODS PERU LLC C CORP -232,909. 170,118. 50.00% X
CHAKIPI COLOMBIA S.A.S
BRR MAMONAL DG 31 100 179 CENTRO INDUSTRIAL Y
CARTAGENA, COLOMBIA DISTRIBUTION OF GOODS COLOMBIA FONDO ACCESO C CORP -232,909. 170,118. 50.00% X
FONDO ACCESO S.A.S.
CALLE 93A NO. 14-17 OF. 707 ACCESSO FUND
BOGOTA, COLOMBIA INVESTMENT COLOMBIA LLC C CORP -8,991. 782,783. 50.00% X
MOYO DEVELOPMENT COMPANY
1271 AVENUE OF AMERICAS ACACIA DEV.
NEW YORK, NY 10020 INVESTMENT DE CORP C CORP 0. 586,210. 40.00% X
MOYO NUTS AND SEEDS LIMITED
PO BOX 5133 REALY HOUSE MOYO DEV.
CHURCH HILL RD LIMBE, MALAWI NUT PROCESSING MALAWI COMPANY C CORP 40.00% X
RUAHA DEVELOPMENT COMPANY LIMITED
IMMMA HSE PLOT NO.357,UN RD PO BX 72484 ACACIA DEV.
UPANGA DAR, EL SALVADOR FARMING TANZANIA CORP C CORP 100% X
TUKULA FARMING COMPANY LTD.
PO BOX 5133 REALY HOUSE ACACIA DEV.
CHURCH HILL RD LIMBE, MALAWI FARMING MALAWI CORP C CORP 100% X
632224 04-01-16
60
Section512(b)(13)controlled
entity?
Legal domicile(state orforeigncountry)
63222404-01-16
Part IV Continuation of Identification of Related Organizations Taxable as a Corporation or Trust
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Yes No
Schedule R (Form 990)
Name, address, and EINof related organization
Primary activity Direct controllingentity
Type of entity(C corp, S corp,
or trust)
Share of totalincome
Share ofend-of-year
assets
Percentageownership
ACCESO WORLDWIDE FUND INC. - 46-4160920 BILL, HILLARY1271 AVENUE OF AMERICAS & CHELSEANEW YORK, NY 10020 INVESTMENT DE CLINTON C CORP 144,689. 662,462. 100%CHAKIPI ACCESO SA PERUCALLE CASCANUECES MZ M2 ACCESO FUNDLOTE 4 LIMA, PERU DISTRIBUTION OF GOODS LLC C CORP -232,909. 170,118. 50.00%CHAKIPI COLOMBIA S.A.SBRR MAMONAL DG 31 100 179 CENTRO INDUSTRIAL YCARTAGENA, COLOMBIA DISTRIBUTION OF GOODS FONDO ACCESO C CORP -232,909. 170,118. 50.00%FONDO ACCESO S.A.S.CALLE 93A NO. 14-17 OF. 707 ACCESSO FUNDBOGOTA, COLOMBIA INVESTMENT LLC C CORP -8,991. 782,783. 50.00%MOYO DEVELOPMENT COMPANY1271 AVENUE OF AMERICAS ACACIA DEV.NEW YORK, NY 10020 INVESTMENT DE CORP C CORP 0. 586,210. 40.00%MOYO NUTS AND SEEDS LIMITEDPO BOX 5133 REALY HOUSE MOYO DEV.CHURCH HILL RD LIMBE, MALAWI NUT PROCESSING COMPANY C CORP 40.00%RUAHA DEVELOPMENT COMPANY LIMITEDIMMMA HSE PLOT NO.357,UN RD PO BX 72484 ACACIA DEV.UPANGA DAR, EL SALVADOR FARMING CORP C CORP 100%TUKULA FARMING COMPANY LTD.PO BOX 5133 REALY HOUSE ACACIA DEV.CHURCH HILL RD LIMBE, MALAWI FARMING CORP C CORP 100%
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
PERU
COLOMBIA
COLOMBIA
MALAWI
TANZANIA
MALAWI
X
X
X
X
X
X
X
X
60
BILL, HILLARY & CHELSEA CLINTON
Schedule R(Form 990) 2016 FOUNDATION 31-1580204 Page 3
Part V Transactions With Related Organizations. Complete if the organization answered Yes on Form 990, Part IV, line 34, 35b, or 36.
Note: Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule. 1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
b Gift, grant, or capital contribution to related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
c Gift, grant, or capital contribution from related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
d Loans or loan guarantees to or for related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
e Loans or loan guarantees by related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
f Dividends from related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
g Sale of assets to related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
h Purchase of assets from related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
i Exchange of assets with related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
j Lease of facilities, equipment, or other assets to related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
k Lease of facilities, equipment, or other assets from related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
l Performance of services or membership or fundraising solicitations for related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
m Performance of services or membership or fundraising solicitations by related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
o Sharing of paid employees with related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
p Reimbursement paid to related organization(s) for expenses ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
q Reimbursement paid by related organization(s) for expenses ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
r Other transfer of cash or property to related organization(s) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
s Other transfer of cash or property from related organization(s) � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 1 s 2 If the answer to any of the above is Yes, see the instructions for information on who must comple t this line, including covered relationships and transaction thresholds.
(a) (b) (c) (d) Name of related organization Transaction Amount involved Method of determining amount involved
type (a-s)
X
I
X
I
X
I
X
I
X
I
X
X
X
X
X
X
X
X
ACACIA DEVELOPMENT CO
ACCESO FUND LLC
ACCESO PEANUT ENTERPRISE CORPORATION
ACCESSO WORLDWIDE FUND INC
ACCESSO WORLDWIDE FUND INC
(6) CLINTON FOUNDATION INSALINGSSTIFTELSE 632163 09-06-16
B
B
P
B
C
C
61
251,600.
1,216,608.
339,299.
644,104.
532,058.
4,984,270.
Schedule R (Form 990) 2016 632163 09-06-16
3
Part V Transactions With Related Organizations.
Note: Yes No
1
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
(i) (ii) (iii) (iv) 1a
1b
1c
1d
1e
1f
1g
1h
1i
1j
1k
1l
1m
1n
1o
1p
1q
1r
1s
2
(a) (b) (c) (d)
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
Receipt of interest, annuities, royalties, or rent from a controlled entity ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gift, grant, or capital contribution to related organization(s)
Gift, grant, or capital contribution from related organization(s)
Loans or loan guarantees to or for related organization(s)
Loans or loan guarantees by related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dividends from related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sale of assets to related organization(s)
Purchase of assets from related organization(s)
Exchange of assets with related organization(s)
Lease of facilities, equipment, or other assets to related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Lease of facilities, equipment, or other assets from related organization(s)
Performance of services or membership or fundraising solicitations for related organization(s)
Performance of services or membership or fundraising solicitations by related organization(s)
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sharing of paid employees with related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Reimbursement paid to related organization(s) for expenses
Reimbursement paid by related organization(s) for expenses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other transfer of cash or property to related organization(s)
Other transfer of cash or property from related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
��������������������������������������������������������
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
Name of related organization Transactiontype (a-s)
Amount involved Method of determining amount involved
XXX
X
X
X
X
X
XXXXX
XXX
X
X
251,600.
1,216,608.
339,299.
644,104.
532,058.
4,984,270.
B
B
P
B
C
C
ACACIA DEVELOPMENT CO
ACCESO FUND LLC
ACCESO PEANUT ENTERPRISE CORPORATION
ACCESSO WORLDWIDE FUND INC
ACCESSO WORLDWIDE FUND INC
CLINTON FOUNDATION INSALINGSSTIFTELSE
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
FMV
FMV
FMV
FMV
FMV
FMV
X
61
BILL, HILLARY & CHELSEA CLINTON
Schedule R (Form 990) FOUNDATION 31-1580204
I Part V Continuation of Transactions With Related Organizations (Schedule R (Form 990), Part V, line 2)
(a) Name of other organization
NUTS AND SEEDS
NUTS AND SEEDS
(b) Transaction
type (a-r)
R
D
(c) Amount involved
819,273.
819,273.
(d) Method of determining
amount involved
632225 04-01-16
62
63222504-01-16
Part V Continuation of Transactions With Related Organizations
(d)(a) (b) (c)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
Schedule R (Form 990)
(Schedule R (Form 990), Part V, line 2)
Method of determiningamount involved
Transactiontype (a-r)
Amount involvedName of other organization
MOYO NUTS AND SEEDS R 819,273.
MOYO NUTS AND SEEDS D 819,273.
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
FMV
FMV
62
BILL, HILLARY & CHELSEA CLINTON
Schedule R(Form 990) 2016 FOUNDATION 31-1580204 Page 4
Part VI Unrelated Organizations Taxable as a Partnership. Complete if the organization answered Yes on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a) I (b) I (c) I (d) I (e) I (f) I (g) I (h) I (i) I (j) I (k)
Areall I I I I I Name, address, and EIN I Primary activity Legal domicile Predominant income partnerssec. Share of I Share of I Dispropor- I Code V-UBI
Generalor Percentage I 501(c)(3) tion a t e m a naging
of enti t y (state or foreign (related, unrelated , orgs.? total end-of-year amount in box 20
allocations? partne r ? ownership exc l uded from tax un der of Schedule K-1
country) I sections 512-514 Yes No income assets Yes No (Form 1065 Yes No
Schedule R (Form 990) 2016
632164 09-06-16
63
Are allpartners sec.
501(c)(3)orgs.?
Dispropor-tionate
allocations?
General ormanagingpartner?
632164 09-06-16
Yes No Yes No Yes N
4
Part VI Unrelated Organizations Taxable as a Partnership.
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
o
Schedule R (Form 990) 2016
Predominant income(related, unrelated,
excluded from tax undersections 512-514)
Code V-UBIamount in box 20of Schedule K-1
(Form 1065)
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
Name, address, and EINof entity
Primary activity Legal domicile(state or foreign
country)
Share oftotal
income
Share ofend-of-year
assets
Percentageownership
BILL, HILLARY & CHELSEA CLINTON31-1580204FOUNDATION
63
BILL, HILLARY & CHELSEA CLINTON
Schedule R(Form 990) 2016 FOUNDATION 31-1580204 Page 5 Part VII I Supplemental Information.
Provide additional information for responses to questions on Schedule R. See instructions.
PART IV, IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST:
NAME OF RELATED ORGANIZATION:
ACACIA DEVELOPMENT CO
DIRECT CONTROLLING ENTITY: BILL, HILLARY & CHELSEA CLINTON FOUNDATION
NAME OF RELATED ORGANIZATION:
ACCESO WORLDWIDE FUND INC.
DIRECT CONTROLLING ENTITY: BILL, HILLARY & CHELSEA CLINTON FOUNDATION
632165 09-06-16 Schedule R (Form 990) 2016 64
13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
632165 09-06-16
5
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016 Page
Provide additional information for responses to questions on Schedule R. See instructions.
Part VII Supplemental Information.
PART IV, IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS CORP OR TRUST:
NAME OF RELATED ORGANIZATION:
ACACIA DEVELOPMENT CO
DIRECT CONTROLLING ENTITY: BILL, HILLARY & CHELSEA CLINTON FOUNDATION
NAME OF RELATED ORGANIZATION:
ACCESO WORLDWIDE FUND INC.
DIRECT CONTROLLING ENTITY: BILL, HILLARY & CHELSEA CLINTON FOUNDATION
FOUNDATION 31-1580204BILL, HILLARY & CHELSEA CLINTON
64 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
EXTENDED TO NOVEMBER 15, 2017
Exempt Organization Business Income Tax Return (and proxy tax under section 6033(e))
For calendar year 2016 or other tax year beginning __________________________ ,and ending _______________________
| Information about Form 990-T and its instructions is available at www.irs.gov/form990t.
| Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).
Name of organization ( [1 Check box if name changed and see instructions.) BILL, HILLARY & CHELSEA CLINTON
Print FOUNDATION or Number, street, and room or suite no. If a P.O. box, see instructions.
Type 1200 PRESIDENT CLINTON AVE
City or town, state or province, country, and ZIP or foreign postal code LITTLE ROCK, AR 72201
Form 990-T
Department of the Treasury Internal Revenue Service
A [1 X Checkboxif address changed
B Exempt under section
[1X 501(c )(3 )
[1 408(e) [1220
(e)
[1408A [1530
(a)
2016 (Employees' trust, see instructions.)
31-1580204 Unrelated business activity codes (See instructions.)
25990 722320
C Bookvalueofallassets r a t e n d o f y e a r F G oup exemption number (See instructions.) | 335,481,436. G Check organization type | [1X 50 1(c) corporation [1 50 1
(c) trust [1 40 1(a) trust [1 Other trust
H Describe the organization's primary unrelated business activity. | CATERING, MUSEUM SALES & PARTNERSHIP INVESTMENTS
I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? ~ ~ ~ ~ ~ ~ | [1 Yes [1X No
If Yes, enter the name and identifying number of the parent corporation. |
J The books are in care of | ANDREW KESSEL, CFO Telephone number | 510-748-0471
Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net 1 a Gross receipts or sales 2,665,805. I
b Less returns and allowances ______________________ c Balance ~ ~ ~ | _____________ 2 Cost of goods sold (Schedule A, line 7) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3 Gross profit. Subtract line 2 from line 1c ~~~~~~~~~~~~~~~~ 4a Capital gain net income (attach Schedule D) ~~~~~~~~~~~~~~~
b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) ~~~~~~
c Capital loss deduction for trusts ~~~~~~~~~~~~~~~~~~~~ 5 Income (loss) from partnerships and S corporations (attach statement) ~~~ 6 Rent income (Schedule C) ~~~~~~~~~~~~~~~~~~~~~~ 7 Unrelated debt-financed income (Schedule E) ~~~~~~~~~~~~~~ 8 Interest, annuities, royalties, and rents from controlled organizations (Sch . F)~ 9 Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G)
10 Exploited exempt activity income (Schedule I) ~~~~~~~~~~~~~~ 11 Advertising income (Schedule J) ~~~~~~~~~~~~~~~~~~~~ 12 Other income (See instructions; attach schedule) ~~~~~~~~~~~~
1c 2 3
4a 4b 4c 5 6 7 8 9 10 11
2,665,805. 642,608.
2,023,197. 89,704.
141,871. STMT 1
2,023,197. 89,704.
141,871.
13 Total. Combine lines 3 through 12 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... I 13 I 2,254,772.
Part II I Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.)
14 Compensation of officers, directors, and trustees (Schedule K) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 15 Salaries and wages ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 16 Repairs and maintenance ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 17 Bad debts ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 18 Interest (attach schedule) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 19 Taxes and licenses ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 20 Charitable contributions (See instructions for limitation rules) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 21 Depreciation (attach Form 4562) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 21 22 Less depreciation claimed on Schedule A and elsewhere on return ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2 2a 23 Depletion ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 24 Contributions to deferred compensation plans ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 25 Employee benefit programs ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 26 Excess exempt expenses (Schedule I) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 27 Excess readership costs (Schedule J) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 28 Other deductions (attach schedule) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~S~EE~~ST~A~TE~M~EN~T~
2 ~ ~ ~ ~ ~ ~
29 Total deductions. Add lines 14 through 28 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 30 Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 31 Net operating loss deduction (limited to the amount on line 30) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~S~EE~~ST~A~TE~ME~N~T~
3 ~ ~ ~ ~ ~ ~
32 Unrelated business taxable income before specific deduction. Subtract line 31 from line 30 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 33 Specific deduction (Generally $1,000, but see line 33 instructions for exceptions) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 34 Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or
I 2,254,772.
14
15 1,333,660.
16 57,630. 17
19 15,207. 20
2 2b 23 2 4 8,146. 2 5 46,097. 26 27 2 8 441,888.
29 1,902,628. 3 0 352,144. 3 1 352,144. 3 2 0. 3 3 1,000.
line32 ............................................................................................................................................................... 34 I 0. 623701 01-18-17 LHA For Paperwork Reduction Act Notice, see instructions. Form 990-T (2016)
66 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0687Form
For calendar year 2016 or other tax year beginning , and ending .
Department of the TreasuryInternal Revenue Service
Open to Public Inspection for501(c)(3) Organizations Only
Employer identification number(Employees' trust, seeinstructions.)
Unrelated business activity codes(See instructions.)
Book value of all assetsat end of year
623701 01-18-17
| Information about Form 990-T and its instructions is available at
| Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).DA
B Printor
TypeE
C F
G
H
I
J(A) Income (B) Expenses (C) Net
1
2
3
4
5
6
7
8
9
10
11
12
13
a
b
a
b
c
c 1c
2
3
4a
4b
4c
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
14
15
16
17
18
19
20
21
22a 22b
23
24
25
26
27
28
29
30
31
32
33
34
Total deductions.
Unrelated business taxable income.
For Paperwork Reduction Act Notice, see instructions.
Total.
Check box ifaddress changed
Name of organization ( Check box if name changed and see instructions.)
Exempt under section
501( )( ) Number, street, and room or suite no. If a P.O. box, see instructions.
220(e)408(e)
408A 530(a) City or town, state or province, country, and ZIP or foreign postal code
529(a)
|Group exemption number (See instructions.)
|Check organization type 501(c) corporation 501(c) trust 401(a) trust Other trust
Describe the organization's primary unrelated business activity. |
During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
If "Yes," enter the name and identifying number of the parent corporation.
~~~~~~ | Yes No|
| |The books are in care of Telephone number
Gross receipts or sales
Less returns and allowances Balance ~~~ |
Cost of goods sold (Schedule A, line 7)
Gross profit. Subtract line 2 from line 1c
Capital gain net income (attach Schedule D)
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~
Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) ~~~~~~
Capital loss deduction for trusts ~~~~~~~~~~~~~~~~~~~~
Income (loss) from partnerships and S corporations (attach statement)
Rent income (Schedule C)
~~~
~~~~~~~~~~~~~~~~~~~~~~
Unrelated debt-financed income (Schedule E) ~~~~~~~~~~~~~~
Interest, annuities, royalties, and rents from controlled organizations (Sch. F)~
Exploited exempt activity income (Schedule I)
Advertising income (Schedule J)
Other income (See instructions; attach schedule)
Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G)
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Combine lines 3 through 12�������������������
Compensation of officers, directors, and trustees (Schedule K)
Salaries and wages
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Repairs and maintenance
Bad debts
Interest (attach schedule)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Taxes and licenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Charitable contributions (See instructions for limitation rules) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Depreciation (attach Form 4562)
Less depreciation claimed on Schedule A and elsewhere on return
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Depletion
Contributions to deferred compensation plans
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Employee benefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Excess exempt expenses (Schedule I)
Excess readership costs (Schedule J)
Other deductions (attach schedule)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 14 through 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 ~~~~~~~~~~~~
Net operating loss deduction (limited to the amount on line 30)
Unrelated business taxable income before specific deduction. Subtract line 31 from line 30
Specific deduction (Generally $1,000, but see line 33 instructions for exceptions)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or
line 32 �����������������������������������������������������
Form (2016)
(See instructions for limitations on deductions.)(Except for contributions, deductions must be directly connected with the unrelated business income.)
LHA
www.irs.gov/form990t.
(and proxy tax under section 6033(e))
Part I Unrelated Trade or Business Income
Part II Deductions Not Taken Elsewhere
990-T
Exempt Organization Business Income Tax Return990-T
2016
STMT 1
SEE STATEMENT 2
SEE STATEMENT 3
31-1580204FOUNDATION
1200 PRESIDENT CLINTON AVE
LITTLE ROCK, AR 72201
CATERING, MUSEUM SALES & PARTNERSHIP INVESTMENTS
X
X
X
1,333,660.
57,630.
15,207.
8,146.46,097.
642,608.2,023,197.2,023,197.
89,704.
141,871.
441,888.1,902,628.
352,144.352,144.
0.1,000.
0.
2,254,772.
525990 722320
c
335,481,436.
EXTENDED TO NOVEMBER 15, 2017
ANDREW KESSEL, CFO 510-748-0471
X
BILL, HILLARY & CHELSEA CLINTON
2,665,805. 2,665,805.
89,704.
141,871.
2,254,772.
3
66 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form 990-T(2016) FOUNDATION 31-1580204 Page 3
Schedule A - Cost of Goods Sold. Enter method of inventory valuation | N/A 1 Inventory at beginning of year ~ ~ ~ 1 0. 6 Inventory at end of year ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 6 0. 2 Purchases ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2 642,608. 7 Cost of goods sold. Subtract line 6
3 Cost of labor ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 3 from line 5. Enter here and in Part I, 4a Additional section 263A costs line 2 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 7 642,608.
(attach schedule) ~ ~ ~ ~ ~ ~ ~ ~ 4 a 8 Do the rules of section 263A (with respect to Yes No
b Other costs (attach schedule) ~ ~ ~ 4 b ____________________ property produced or acquired for resale) apply to 5 Total. Add lines 1 through 4b � � � 5 642,608. the organization? � � � � � � � � � � � � � � � � � � � � � � � X
Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property) (see instructions)
1. Description of property
(2)
2. Rent received or accrued
(a) From personal property (if the percentage of (b) From real and personal property (if the percentage rent for personal property is more than of rent for personal property exceeds 50% or if
10% but not more than 50%) the rent is based on profit or income)
3(a) Deductions directly connected with the income in columns 2(a) and 2(b) (attach schedule)
Total 0. Total
(c) Total income. Add totals of columns 2(a) and 2(b). Enter
here and on page 1, Part I, line 6, column (A) � � � � � � � |Schedule E- Unrelated Debt-Financed Inc
0 .
(b) Total deductions.
0 . E n t e r h e r e a n d o n p a g e 1 , Part I, line 6, column (B)
3. Deductions directly connected with or allocable to debt-financed property
(a) Straight line depreciation (b) Other deductions (attach schedule) (attach schedule)
0.
1. Description of debt-financed property
2. Gross income from or allocable to debt-
financed property
4. Amount of average acquisition 5 . Average adjusted basis debt on or allocable to debt-financed of or allocable to
property (attach schedule) debt-financed property (attach schedule)
6. Column 4 divided by column 5
%
7. Gross income reportable (column
2 xcolumn 6)
Enter here and on page 1
Part I, line 7, column (A).
8. Allocable deductions (column 6 x total of columns
3(a) and 3(b))
Enter here and on page 1 , Part I, line 7, column (B).
0. 0.
| 0.
Form 990-T (2016)
%
Totals ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ |
623721 01-18-17
68 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Description of property
Rent received or accrued
Deductions directly connected with the income incolumns 2(a) and 2(b) (attach schedule) From personal property (if the percentage of
rent for personal property is more than 10% but not more than 50%)
From real and personal property (if the percentageof rent for personal property exceeds 50% or if
the rent is based on profit or income)
Total Total
Enter here and on page 1,Part I, line 6, column (B)
Deductions directly connected with or allocableto debt-financed property Gross income from
or allocable to debt-financed property
Straight line depreciation(attach schedule)
Other deductions(attach schedule)
Description of debt-financed property
Amount of average acquisition debt on or allocable to debt-financed
property (attach schedule)
Average adjusted basisof or allocable to
debt-financed property(attach schedule)
Column 4 divided by column 5
Gross incomereportable (column
2 x column 6)
Allocable deductions(column 6 x total of columns
3(a) and 3(b))
Enter here and on page 1,
Part I, line 7, column (A).
Enter here and on page 1,
Part I, line 7, column (B).
623721 01-18-17
3
1
2
3
4
1
2
3
4a
4b
5
6
7
8
6
7
Cost of goods sold.
a
b
Yes No
Total.5
1.
2.3(a)
(a) (b)
(b) Total deductions.(c) Total income.
3.2.
(a) (b)1.
4. 7.5. 6. 8.
Totals
Total dividends-received deductions
990-T
Form 990-T (2016) Page
|
Inventory at beginning of year
Purchases
~~~ Inventory at end of year ~~~~~~~~~~~~
~~~~~~~~~~~ Subtract line 6
Cost of labor~~~~~~~~~~~ from line 5. Enter here and in Part I,
line 2Additional section 263A costs
(attach schedule)
Other costs (attach schedule)
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~ Do the rules of section 263A (with respect to
property produced or acquired for resale) apply to
the organization?
~~~
Add lines 1 through 4b ��� �����������������������
Add totals of columns 2(a) and 2(b). Enter
here and on page 1, Part I, line 6, column (A) ������� | � |
%
%
%
%
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
included in column 8 ��������������������������������� |
Form (2016)
Enter method of inventory valuation
(see instructions)
(1)
(2)
(3)
(4)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(1)
(2)
(3)
(4)
Schedule A - Cost of Goods Sold.
Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property)
Schedule E - Unrelated Debt-Financed Income
0.
N/A0. 0.
0. 0.
642,608.
642,608.
642,608. X
31-1580204FOUNDATIONBILL, HILLARY & CHELSEA CLINTON
0.0.
0. 0.
68 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
Form 990-T(2016) FOUNDATION 31-1580204 Page 4
Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions)
Exempt Controlled Organizations 1. Name of controlled organization 2. Employer 3. Net unrelated income 4. Total of specified 5. Part of column 4 that is 6. Deductions directly
identification (loss) (see instructions) payments made included in the controlling connected with income number organization's gross income in column 5
e mpt Controlled Organizations 7 . Taxable Income 8. Net unrelated income (loss) 9. Total of specified payments 10. Part of column 9 that is included 11. Deductions directly connected
(see instructions) made in the controlling organization's with income in column 10
gross income
Add columns 5 and 10. Add columns 6 and 11.
Enter here and on page 1 , Part I, Enter here and on page 1 , Part I,
line 8, column (A). line 8, column (B).
Totals � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � J 0. 0.
Schedule G - Investment Income of a Section 501(c)(7), (9), or (17) Organization (see instructions)
3. Deductions Total deductions Description of inc o me Amount of inc o me dire c tly c o nne c ted
4. Set-asides 5. 1. 2. and set-asides
__________________________________________________________________________ ___________________ (attach schedule) (attach schedule) (col. 3 plus col. 4)
(1) _______________________ _______________________ _______________________ _______________________
(2) ________________ ________________ ________________ ________________
(3)
Enter here and on page 1 , Enter here and on page 1 , Part I, line 9, column (A). Part I, line 9, column (B).
Totals� � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
9
0. _________
0.
ule I - Exploited Exempt Activity Income, Other Than Advertising Income (see instructions)
. ncome(loss) 2. 3.
4 Net i Expenses . Excessexempt Gross from unrelatedtradeor 5. 7 Grossincome 1. directly connected 6. Expenses expenses (column Description of unrelated business business (column 2 from activity that with production attributable to 6 minus c o lumn 5, exploit e d activity inc o me from minus c o lumn 3). If a is not unrelat e d of unrelat e d c o lumn 5 but not m o re t h an trade o rbusine s s gain, c o mpute c o ls. 5 business inc o m e business inc o m e c o lumn 4). t h rough 7.
(2)
(3)
(4)
(1)
(2)
(3)
Enter here and on Enter here and on page 1, PartI, page 1, PartI,
line 10, col. (A). line 10, col. (B).
� � � � � � � � 9 0. 0. _____
leJ - Advertising Income (see instructions )
Income From Periodicals Reported on a Consolidated Basis
I 2.
4. Advertising gain G ross 3. Direct I or (loss) (col. 2 minus 1. Name of periodical advertising advertising costs I col. 3). If a gain, compute income I cols. 5 through 7.
5. Circulation 6. Readership income costs
Enter here and on page 1,
Part II, line 26.
0.
7. Excess readership costs (column 6 minus column 5, but not more
than column 4).
9 0. 0. 0.
Form 990-T (2016) 623731 01-18-17
69 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Employer Net unrelated income Total of specified Deductions directlyPart of column 4 that is Name of controlled organizationidentification
number(loss) (see instructions) payments made included in the controlling
organization's gross incomeconnected with income
in column 5
Taxable Income Net unrelated income (loss) Total of specified payments Part of column 9 that is included Deductions directly connectedin the controlling organization's
gross incomemade(see instructions) with income in column 10
Add columns 5 and 10.
Enter here and on page 1, Part I,
line 8, column (A).
Add columns 6 and 11.
Enter here and on page 1, Part I,
line 8, column (B).
Deductionsdirectly connected(attach schedule)
Total deductionsand set-asides
(col. 3 plus col. 4)
Set-asides(attach schedule)
Description of income Amount of income
Enter here and on page 1,Part I, line 9, column (A).
Enter here and on page 1,Part I, line 9, column (B).
Description ofexploited activity
Grossunrelated business
income fromtrade or business
Expensesdirectly connected
with productionof unrelated
business income
Net income (loss)from unrelated trade or
business (column 2minus column 3). If again, compute cols. 5
through 7.
Gross incomefrom activity thatis not unrelated
business income
Expensesattributable to
column 5
Excess exemptexpenses (column6 minus column 5,but not more than
column 4).
Enter here and onpage 1, Part I,
line 10, col. (A).
Enter here and onpage 1, Part I,
line 10, col. (B).
Enter here andon page 1,
Part II, line 26.
Grossadvertising
income
Directadvertising costs
Advertising gainor (loss) (col. 2 minus
col. 3). If a gain, computecols. 5 through 7.
Circulationincome
Readershipcosts
Excess readershipcosts (column 6 minuscolumn 5, but not more
than column 4).
Name of periodical
623731 01-18-17
4
1. 2. 3. 4. 5. 6.
7. 8. 9. 10. 11.
Totals
3. 5.4.1. 2.
Totals
1. 2. 3. 4.
5. 6. 7.
Totals
2. 3. 4.
5. 6. 7.
1.
Totals
Form 990-T (2016) Page
����������������������������������������
������������������������������
����������
(carry to Part II, line (5)) ��
(see instructions)
Exempt Controlled Organizations
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
Form (2016)
Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations
Schedule G - Investment Income of a Section 501(c)(7), (9), or (17) Organization
Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income
Schedule J - Advertising Income
Income From Periodicals Reported on a Consolidated BasisPart I
990-T
J
9
9
9
0.
31-1580204FOUNDATIONBILL, HILLARY & CHELSEA CLINTON
0. 0.
0. 0. 0.
0. 0.
0. 0.
69 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Form 990-T (2016)
BILL, HILLARY & CHELSEA CLINTON
Form 990-T(2016) FOUNDATION 31-1580204 Page 5
I Part II I Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns 2 through 7 on a line-by-line basis.)
I2.
4. Advertising gain 7. Excess readership Gross 3. Direct I or (loss) (col. 2 minus I 5. Circulation I 6. Readership I costs (column 6 minus 1. Name of periodical advertising advertising costs col. 3). If a gain, compute income costs column 5, but not more income I cols. 5 through 7. I I I than column 4).
(1) _____________________ ____________________
(2) _______________ ______________
(3) _______________ ______________
(4) _______________ ______________
TotalsfromPartI � � � � � � � 9 0. 0. Enter here and on Enter here and on
page 1, PartI, page 1, PartI, line 11 ,col. (A). line 11 ,col. (B).
Totals, Part II (lines 1-5 ) 9 0. 0.
0. Enter here and
on page 1, Part II, line 27.
0.
(see instructions)
623732 01-18-17
70 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Grossadvertising
income
Directadvertising costs
Advertising gainor (loss) (col. 2 minus
col. 3). If a gain, computecols. 5 through 7.
Circulationincome
Readershipcosts
Excess readershipcosts (column 6 minuscolumn 5, but not more
than column 4).
Name of periodical
Enter here and onpage 1, Part I,
line 11, col. (A).
Enter here and onpage 1, Part I,
line 11, col. (B).
Enter here andon page 1,
Part II, line 27.
Percent oftime devoted to
business
Compensation attributableto unrelated businessTitleName
623732 01-18-17
5
2. 3. 4.
5. 6. 7.
1.
Totals from Part I
Totals,
3. 4.2.1.
Total.
990-T
Form 990-T (2016) Page
�������
Part II (lines 1-5)�����
%
%
%
%
Enter here and on page 1, Part II, line 14 �����������������������������������
Form (2016)
(For each periodical listed in Part II, fill incolumns 2 through 7 on a line-by-line basis.)
(1)
(2)
(3)
(4)
(see instructions)
(1)
(2)
(3)
(4)
Income From Periodicals Reported on a Separate BasisPart II
Schedule K - Compensation of Officers, Directors, and Trustees
99
9
31-1580204FOUNDATIONBILL, HILLARY & CHELSEA CLINTON
0. 0.
0. 0. 0.
0.
0.
70 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON FOUNDATI
FORM 990-T INCOME (LOSS) FROM PARTNERSHIPS AND S CORPORATIONS
DESCRI PTION } } } } } } } } } } } SUMMIT ROCK DIVERSIFIED - ORDINARY INCOME(LOSS) SUMMIT ROCK HEDGED EQUITY PORTFOLIO, L.P - ORDINARY INCOME (LOSS) SUMMIT ROCK SELECT EQUITY PORTFOLIO, L.P - ORDINARY INCOME (LOSS) SUMMIT ROCK STRATEGIC FIXED INCOME - ORDINARY INCOME(LOSS) SUMMIT ROCK PRIVATE EQUITY PORTFOLIO II - ORDINARY INCOME (LOSS)
TOTAL TO FORM 990-T, PAGE 1, LINE 5
FORM 990-T OTHER DEDUCTIONS
DESCRI PTION } } } } } } } } } } } EQUIPMENT RENTAL BANQUET EXPENSES OTHER EXPENSES FACILITY EXPENSES BANK & MISCELLANEOUS MARKETING AND OUTREACH TELEPHONE TRAVEL
TOTAL TO FORM 990-T, PAGE 1, LINE 28
31-158 0204 } } } } } } } } } }
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ STATEMENT 1
} } } } } } } } } } } } }
AMOUNT } } } } } } } } } } } } }
14,607.
-12,390.
-2,450.
142,623.
-519.
} } } } } } } } } } } } } 141,871.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ STATEMENT 2 } } } } } } } } } } } } }
AMOUNT
5,435.
210,236.
131,333.
44,434.
17,875.
21,022.
8,363.
3,190.
441,888.
FORM 990-T NET OPERATING LOSS DEDUCTION } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } }
LOSS PREVIOUSLY LOSS
TAX YEAR LOSS SUSTAINED APPLIED REMAINING } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } } 12/31/11 34,437. 0. 34,437.
12/31/12 180,700. 0. 180,700.
12/31/13 201,666. 0. 201,666.
12/31/14 52,086. 0. 52,086.
12/31/15 115,325. 0. 115,325.
NOL CARRYOVER AVAILABLE THIS YEAR 584,214.
STATEMENT 3
AVAI LABLE THIS YEAR } } } } } } } } } } } }
34,437.
180,700.
201,666.
52,086.
115,325.
584,214.
71 STATEMENT(S) 1, 2 , 3 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}BILL, HILLARY & CHELSEA CLINTON FOUNDATI 31-1580204
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~STATEMENT 1FORM 990-T INCOME (LOSS) FROM PARTNERSHIPS
AND S CORPORATIONS}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
DESCRIPTION AMOUNT}}}}}}}}}}} }}}}}}}}}}}}}}SUMMIT ROCK DIVERSIFIED - ORDINARY INCOME(LOSS) 14,607.SUMMIT ROCK HEDGED EQUITY PORTFOLIO, L.P - ORDINARYINCOME(LOSS) -12,390.SUMMIT ROCK SELECT EQUITY PORTFOLIO, L.P - ORDINARYINCOME(LOSS) -2,450.SUMMIT ROCK STRATEGIC FIXED INCOME - ORDINARY INCOME(LOSS) 142,623.SUMMIT ROCK PRIVATE EQUITY PORTFOLIO II - ORDINARYINCOME(LOSS) -519.
}}}}}}}}}}}}}}TOTAL TO FORM 990-T, PAGE 1, LINE 5 141,871. ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~STATEMENT 2FORM 990-T OTHER DEDUCTIONS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT}}}}}}}}}}} }}}}}}}}}}}}}}EQUIPMENT RENTAL 5,435.BANQUET EXPENSES 210,236.OTHER EXPENSES 131,333.FACILITY EXPENSES 44,434.BANK & MISCELLANEOUS 17,875.MARKETING AND OUTREACH 21,022.TELEPHONE 8,363.TRAVEL 3,190.
}}}}}}}}}}}}}}TOTAL TO FORM 990-T, PAGE 1, LINE 28 441,888. ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~STATEMENT 3FORM 990-T NET OPERATING LOSS DEDUCTION
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} LOSS PREVIOUSLY LOSS AVAILABLETAX YEAR LOSS SUSTAINED APPLIED REMAINING THIS YEAR}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}12/31/11 34,437. 0. 34,437. 34,437.12/31/12 180,700. 0. 180,700. 180,700.12/31/13 201,666. 0. 201,666. 201,666.12/31/14 52,086. 0. 52,086. 52,086.12/31/15 115,325. 0. 115,325. 115,325.
}}}}}}}}}}}}}} }}}}}}}}}}}}}}NOL CARRYOVER AVAILABLE THIS YEAR 584,214. 584,214. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~
STATEMENT(S) 1, 2, 371 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON FOUNDATI 31-158 0204
FORM 990-T NAME OF FOREIGN COUNTRY IN WHICH STATEMENT 4 ORGANIZATION HAS FINANCIAL INTEREST
NAME OF COUNTRY
AUSTRALIA COLOMBIA EL SALVADOR HAITI INDIA KENYA MALAWI PERU RWANDA TANZANIA
72 STATEMENT(S) 4 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}BILL, HILLARY & CHELSEA CLINTON FOUNDATI 31-1580204
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~STATEMENT 4FORM 990-T NAME OF FOREIGN COUNTRY IN WHICH
ORGANIZATION HAS FINANCIAL INTEREST}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
NAME OF COUNTRY}}}}}}}}}}}}}}}AUSTRALIACOLOMBIAEL SALVADORHAITIINDIAKENYAMALAWIPERURWANDATANZANIA
STATEMENT(S) 472 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
SCHEDULE D (Form 1120) Department of the Treasury Internal Revenue Service
Name
Capital Gains and Losses OMB No. 1 5 4 5 - 0 1 2 3
| Attach to Form 1120, 1120-C, 1120-F, 1120-FSC, 1120-H, 1120-IC-DISC, 1120-L, 1120-ND, 1120-PC, 1120-POL, 1120-REIT, 1120-RIC, 1120-SF, or certain Forms 990-T. Information about Schedule D (Form 1120) and its separate instructions is at www.irs.gov/form1 120.
I Employer identification number BILL, HILLARY & CHELSEA CLINTON
FOUNDATION 31-1580204
or See instructions for how to figure the amounts to enter on the lines below. (d) ( e)
Proceeds C o st This form may be easier to complete if you (sales price) (or other basis) round off cents to whole dollars. ________________________ ________________________
1a Totals for all short-term transactions reported on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank andgotoline 1b ________________________ ______________________
1b Totals for all transactions reported on
Form(s) 8949 with BoxA checked _________ ______________________
2 Totals for all transactions reported on
Form(s) 8949 with BoxB checked _________ ______________________
3 Totals for all transactions reported on
Form(s) 8949 with Box C checked _________ ______________________
4 Short-term capital gain from installment sales from Form 6252, line 26 or 37 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 5 Short-term capital gain or (loss) from like-kind exchanges from Form 8824 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 6 Unused capital loss carryover (attach computation) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 7 Net short-term capital gain or (loss). Combine lines 1a through 6 in column h � � � � � � � � � � � Part II
I Long-Term Capital Gainsand Losses - Assets Held More Than
(g) Adjustments to gain (h) Gain or (loss). Subtract or loss from Form(s) 8949, column (e) from column ( d ) and
Part I, line 2, column (g) combine the result with column (g)
~ ~ ~ ~ ~ ~ ~ ~
~ ~ ~ ~ ~ ~ ~ ~ 5
~ ~ ~ ~ ~ ~ ~ ~ 6
7
See instructions for how to figure the amounts I I I I to enter on the lines below. I (d) I (e) I (g) Adjustments to gain I (h) Gain or (loss). Subtract
Proceeds I Cost I or loss from Form(s) 8949, I column (e) from column ( d ) and This form may be easier to complete if you I (sales price) I (or other basis) I Part II, line 2, column (g) combine the result with column (g) round off cents to whole dollars. I I I I 8a Totals for all long-term transactions reported
on Form 1099-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 8949, leave this line blank and go to
8b Totals for all transactions reported on
9 Totals for all transactions reported on
10 Totals for all transactions reported on
- 89,704.
11 Enter gain from Form 4797, line 7 or 9 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 11
12 Long-term capital gain from installment sales from Form 6252, line 26 or 37 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13 Long-term capital gain or (loss) from like-kind exchanges from Form 8824 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 13
14 Capital gain distributions ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 15 Net long-term capital gain or (loss). Combine lines 8a through 14 in column h ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 15 89,704.
Part III I Summary of Parts I and II 16 Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15) ~~~~~~~~~~~~~~~~ 16
17 Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7) ~~~~~~~~ 17 89,704. 18 Add lines 16 and 17. Enter here and on Form 1120, page 1, line 8, or the proper line on other returns. If
the corporation has qualified timber gain, also complete Part IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 18 -
89,704.
Note: If losses exceed gains, see Capital losses in the instructions.
JWA For Paperwork Reduction Act Notice, see the Instructions for Form 1120. Schedule D (Form 1120) 2016
621051
12-27- 16
73 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
OMB No. 1545-0123
Department of the Treasury
Internal Revenue Service
Proceeds(sales price)
Cost(or other basis)
Adjustments to gainor loss from Form(s) 8949,
Part I, line 2, column (g)
Gain or (loss). Subtractcolumn (e) from column (d) and
combine the result with column (g)
Proceeds(sales price)
Cost(or other basis)
Adjustments to gainor loss from Form(s) 8949,Part II, line 2, column (g)
Gain or (loss). Subtractcolumn (e) from column (d) and
combine the result with column (g)
62105112-27-16
SCHEDULE D
| Information about Schedule D (Form 1120) and its separate instructions is at www.irs.gov/form1120.
(Form 1120)
Employer identification number
(d) (e) (g) (h) See instructions for how to figure the amountsto enter on the lines below.
1a
1b
2
3
4
5
6
7
Box A
Box B
Box C
4
5
6
7
(d) (e) (g) (h) See instructions for how to figure the amountsto enter on the lines below.
8a
8b
9
10
11
12
13
14
15
Box D
Box E
Box F
11
12
13
14
15
16
17
18
16
17
18
Note: Capital losses
For Paperwork Reduction Act Notice, see the Instructions for Form 1120. Schedule D (Form 1120) 2016
| Attach to Form 1120, 1120-C, 1120-F, 1120-FSC, 1120-H, 1120-IC-DISC, 1120-L,1120-ND, 1120-PC, 1120-POL, 1120-REIT, 1120-RIC, 1120-SF, or certain Forms 990-T.
Name
This form may be easier to complete if youround off cents to whole dollars.
Totals for all short-term transactionsreported on Form 1099-B for which basiswas reported to the IRS and for which youhave no adjustments (see instructions).However, if you choose to report all thesetransactions on Form 8949, leave this lineblank and go to line 1b
Totals for all transactions reported on
Form(s) 8949 with checked
Totals for all transactions reported on
Form(s) 8949 with checked
Totals for all transactions reported on
Form(s) 8949 with checked
Short-term capital gain from installment sales from Form 6252, line 26 or 37 ~~~~~~~~~~~~~~~~~~~~~~
Short-term capital gain or (loss) from like-kind exchanges from Form 8824 ~~~~~~~~~~~~~~~~~~~~~~
Unused capital loss carryover (attach computation) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Net short-term capital gain or (loss). Combine lines 1a through 6 in column h ���������������������
( )
This form may be easier to complete if youround off cents to whole dollars.
Totals for all long-term transactions reportedon Form 1099-B for which basis wasreported to the IRS and for which you haveno adjustments (see instructions). However,if you choose to report all these transactionson Form 8949, leave this line blank and go toline 8b
Totals for all transactions reported on
Form(s) 8949 with checked
Totals for all transactions reported on
Form(s) 8949 with checked
Totals for all transactions reported on
Form(s) 8949 with checked
Enter gain from Form 4797, line 7 or 9 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Long-term capital gain from installment sales from Form 6252, line 26 or 37 ~~~~~~~~~~~~~~~~~~~~~~
Long-term capital gain or (loss) from like-kind exchanges from Form 8824 ~~~~~~~~~~~~~~~~~~~~~~
Capital gain distributions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Net long-term capital gain or (loss). Combine lines 8a through 14 in column h
Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15) ~~~~~~~~~~~~~~~~
Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7) ~~~~~~~~
Add lines 16 and 17. Enter here and on Form 1120, page 1, line 8, or the proper line on other returns. If
the corporation has qualified timber gain, also complete Part IV
If losses exceed gains, see in the instructions.
JWA
��������
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���������������
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���������������������
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Part I Short-Term Capital Gains and Losses - Assets Held One Year or Less
Part II Long-Term Capital Gains and Losses - Assets Held More Than One Year
Part III Summary of Parts I and II
Capital Gains and Losses
2016
FOUNDATIONBILL, HILLARY & CHELSEA CLINTON
31-1580204
89,704.
89,704.
89,704.
89,704.
73 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
BILL, HILLARY & CHELSEA CLINTON
ScheduleD(Form 1120) 2016 FOUNDATION 31-1580204 Page 2
I Part IV I Alternative Tax for Corporations with Qualified Timber Gain. Complete Part IV only if the corporation has qualified timber gain under section 1201(b). Skip this part if you are filing Form 1120-RIC. See instructions. ___________________________
19 Enter qualified timber gain (as defined in section 1201(b)(2)) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 19 _______________________
20 Enter taxable income from Form 1120, page 1, line 30, or the applicable line ofyourtaxreturn ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 20
21 Enter the smallest of: (a) the amount on line 19; (b) the amount on line 20; or
(c) the amount on Par t III, line 17 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 2 1 ________________________
22 Multiply line 21 by 23.8% (0.238) ........................................................................................................................... 22
23 Subtract line 17 from line 20. If zero or less, enter -0- 23 24 Enter the tax on line 23, figured using the Tax Rate Schedule (or applicable tax rate) appropriate for
the return with which ScheduleD (Form 1120) is being filed ....................................................................................... 24
25 Add lines 21 and 23 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
26 Subtract line 25 from line 20. If zero or less, enter -0- ~~~~~~~~~~~~~~~~
27 Multiply line 26 by 35% (0.35) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
28 Add lines 22, 24, and 27 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 29 Enter the tax on line 20, figured using the Tax Rate Schedule (or applicable tax rate) appropriate for the
return with which ScheduleD (Form 1120) is being filed ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 30 Enter the smaller of line 28 or line 29. Also enter this amount on Form 1120, Schedule J, line 2, or the
Schedule D (Form 1120) 20 16
621052 12-27-16 JWA
74 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Schedule D (Form 1120) 2016
62105212-27-16
2
only
19
20
21
22
23
24
25
26
27
28
29
30
19
20
21
22
24
27
28
29
30
23
25
26
Schedule D (Form 1120) 2016
Page
Complete Part IV if the corporation has
qualified timber gain under section 1201(b). Skip this part if you are filing Form 1120-RIC. See instructions.
Enter qualified timber gain (as defined in section 1201(b)(2))
Enter taxable income from Form 1120, page 1, line 30, or the applicable line
of your tax return
Enter the smallest of: (a) the amount on line 19; (b) the amount on line 20; or
(c) the amount on Part III, line 17
Multiply line 21 by 23.8% (0.238)
Subtract line 17 from line 20. If zero or less, enter -0-
Enter the tax on line 23, figured using the Tax Rate Schedule (or applicable tax rate) appropriate for
the return with which Schedule D (Form 1120) is being filed
Add lines 21 and 23
Subtract line 25 from line 20. If zero or less, enter -0-
Multiply line 26 by 35% (0.35)
Add lines 22, 24, and 27
Enter the tax on line 20, figured using the Tax Rate Schedule (or applicable tax rate) appropriate for the
return with which Schedule D (Form 1120) is being filed
Enter the smaller of line 28 or line 29. Also enter this amount on Form 1120, Schedule J, line 2, or the
applicable line of your tax return
JWA
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
�����������������������������������������
�����������������������������
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
�����������������������������������������
Part IV Alternative Tax for Corporations with Qualified Timber Gain.
BILL, HILLARY & CHELSEA CLINTONFOUNDATION 31-1580204
74 13491114 147227 0227810-0227935.0990 2016.05000 BILL, HILLARY & CHELSEA C 02278101
Checkifself-employed
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Check ifapplicable:
AddresschangeNamechangeInitialreturn
Finalreturn/termin-ated Gross receipts $
AmendedreturnApplica-tionpending
Are all subordinates included?
632001 11-11-16
Beginning of Current Year
Paid
Preparer
Use Only
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. Open to Public Inspection| Information about Form 990 and its instructions is at
A For the 2016 calendar year, or tax year beginning and ending
B C D Employer identification number
E
G
H(a)
H(b)
H(c)
F Yes No
Yes No
I
J
K
Website: |
L M
1
2
3
4
5
6
7
3
4
5
6
7a
7b
a
b
Ac
tivi
tie
s &
Go
vern
an
ce
Prior Year Current Year
8
9
10
11
12
13
14
15
16
17
18
19
Re
ven
ue
a
b
Ex
pe
ns
es
End of Year
20
21
22
Sign
Here
Yes No
For Paperwork Reduction Act Notice, see the separate instructions.
(or P.O. box if mail is not delivered to street address) Room/suite
)501(c)(3) 501(c) ( (insert no.) 4947(a)(1) or 527
|Corporation Trust Association OtherForm of organization: Year of formation: State of legal domicile:
|
|
Net
Ass
ets
orFu
nd B
alan
ces
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.
Signature of officer Date
Type or print name and title
Date PTINPrint/Type preparer's name Preparer's signature
Firm's name Firm's EIN
Firm's address
Phone no.
Form
Name of organization
Doing business as
Number and street Telephone number
City or town, state or province, country, and ZIP or foreign postal code
Is this a group return
for subordinates?Name and address of principal officer: ~~
If "No," attach a list. (see instructions)
Group exemption number |
Tax-exempt status:
Briefly describe the organization's mission or most significant activities:
Check this box 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 1a)
Number of independent voting members of the governing body (Part VI, line 1b)
Total number of individuals employed in calendar year 2016 (Part V, line 2a)
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
Total number of volunteers (estimate if necessary)
Total unrelated business revenue from Part VIII, column (C), line 12
Net unrelated business taxable income from Form 990-T, line 34
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
����������������������
Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~
Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ���
Grants and similar amounts paid (Part IX, column (A), lines 1-3)
Benefits paid to or for members (Part IX, column (A), line 4)
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
~~~~~~~~~~~
~~~~~~~~~~~~~
~~~
Professional fundraising fees (Part IX, column (A), line 11e)
Total fundraising expenses (Part IX, column (D), line 25)
~~~~~~~~~~~~~~
Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 18 from line 12
~~~~~~~~~~~~~
~~~~~~~
����������������
Total assets (Part X, line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
��������������
May the IRS discuss this return with the preparer shown above? (see instructions) ���������������������
LHA Form (2016)
www.irs.gov/form990.
Part I Summary
Signature BlockPart II
990
Return of Organization Exempt From Income Tax990 2016
§
==
999
** PUBLIC DISCLOSURE COPY **
CLINTON HEALTH ACCESS INITIATIVE, INC.27-1414646
383 DORCHESTER AVENUE 400 617-774-0110145,831,195.
BOSTON, MA 02127IRA C. MAGAZINER X
SAME AS C ABOVEX
WWW.CLINTONHEALTHACCESS.ORGX 2009 AR
CHAI IS A GLOBAL HEALTHORGANIZATION COMMITTED TO SAVING LIVES IN THE DEVELOPING WORLD.
97
350970.0.
170,688,566. 142,749,140.0. 0.
99,524. 192,217.47,352. 11,901.
170,835,442. 142,953,258.18,432,471. 12,368,417.
0. 0.70,611,707. 72,957,330.
40,088. 60,000.1,035,062.
61,733,210. 54,527,613.150,817,476. 139,913,360.20,017,966. 3,039,898.
95,237,284. 90,764,479.35,678,582. 28,173,741.59,558,702. 62,590,738.
IRA C. MAGAZINER, CEO/VICE CHAIRMAN
CRAIG KLEIN 11/13/17 P00734640CBIZ TOFIAS 26-3753134500 BOYLSTON STREETBOSTON, MA 02116 617-761-0600
X
SEE SCHEDULE O FOR ORGANIZATION MISSION STATEMENT CONTINUATION
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Code: Expenses $ including grants of $ Revenue $
Expenses $ including grants of $ Revenue $
632002 11-11-16
1
2
3
4
Yes No
Yes No
4a
4b
4c
4d
4e
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part III ����������������������������
Briefly describe the organization's mission:
Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ?
If "Yes," describe these new services on Schedule O.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
If "Yes," describe these changes on Schedule O.
~~~~~~
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.
( ) ( ) ( )
( ) ( ) ( )
( ) ( ) ( )
Other program services (Describe in Schedule O.)
( ) ( )
Total program service expenses |
Form (2016)
2Statement of Program Service AccomplishmentsPart III
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
THE CLINTON HEALTH ACCESS INITIATIVE (CHAI) IS A GLOBAL HEALTHORGANIZATION COMMITTED TO SAVING LIVES, REDUCING THE BURDEN OF DISEASEAND STRENGTHENING INTEGRATED HEALTH SYSTEMS IN THE DEVELOPING WORLD.
X
X
36,319,154. 3,222,392.MATERNAL AND CHILD HEALTH: WOMEN AND CHILDREN BEAR THE BRUNT OF GLOBALDISEASE MORTALITY AND MORBIDITY. WELL-TIMED AND TARGETED INTERVENTIONSCAN DRAMATICALLY REDUCE MORTALITY FOR MOTHERS AND THEIR CHILDREN. CHAIIS WORKING TO ENSURE THAT MOTHERS AND THEIR CHILDREN HAVE ACCESS TOLIFESAVING TREATMENT AND THAT ALL FAMILIES HAVE THE TOOLS TO SAFELYPLAN THEIR FAMILIES TO IMPROVE HEALTH OUTCOMES AND STRENGTHEN THEIRECONOMIC WELL-BEING. CHAI HAS SIGNIFICANTLY INCREASED COVERAGE OFLIFESAVING TREATMENTS FOR DIARRHEA AND PNEUMONIA, THE LARGEST KILLERSOF CHILDREN UNDER FIVE, IMPROVED NUTRITION FOR WOMEN AND CHILDREN ANDIS IMPLEMENTING AN INTEGRATED APPROACH TO DRAMATICALLY AND SUSTAINABLYREDUCE MATERNAL AND NEONATAL MORTALITY BY ADDRESSING CRITICAL GAPS INHEALTH SYSTEMS TO AVERT PREVENTABLE DEATHS THAT OCCUR AROUND
24,092,253. 919,721.GLOBAL HEALTH SPENDING: STRONG HEALTH SYSTEMS ARE THE KEY TOELIMINATING DISEASE, TREATING THOSE WHO ARE SICK AND REDUCINGMORTALITY. WHILE LOW-INCOME COUNTRIES IN AFRICA AND SOUTHEAST ASIAEXPERIENCE OVER HALF OF THE GLOBAL DISEASE BURDEN AND ARE HOME TO 40PERCENT OF THE WORLD'S POPULATION, THEY ACCOUNT FOR ONLY THREE PERCENTOF HEALTH SPENDING. THESE RESOURCE SHORTAGES, COMBINED WITH WEAKNESSESIN DELIVERY SYSTEMS, INCLUDING A SEVERE DEFICIT OF SKILLED HEALTHWORKERS, PREVENT THE POPULATION FROM ACCESSING EVEN BASIC QUALITYSERVICES. CHAI IS WORKING WITH ITS PARTNER GOVERNMENTS TO STRENGTHENAND FUNDAMENTALLY REFORM THEIR HEALTH FINANCING SYSTEMS TO INCREASESUSTAINABILITY AND REDUCE FINANCIAL BARRIERS PREVENTING ACCESS TOESSENTIAL HEALTH SERVICES BY HELPING TO UNDERSTAND NEEDS, ADDRESS GAPS
27,128,978. 1,669,812.HIV/AIDS: SINCE 2002, CHAI HAS WORKED TO IMPROVE ACCESS TO DIAGNOSIS,PREVENTION AND TREATMENT FOR THOSE IMPACTED BY HIV/AIDS IN THEDEVELOPING WORLD. ALONGSIDE OUR PARTNERS, CHAI HAS HELPED SAVE THELIVES OF OVER 11.8 MILLION PEOPLE AND SIGNIFICANTLY LOWERED THE PRICESOF HIGH-QUALITY TREATMENTS. CHAI CATALYZED THE SCALE UP OF PEDIATRICAIDS TREATMENT FROM AROUND 75,000 HIV-INFECTED CHILDREN RECEIVINGTREATMENT IN DEVELOPING COUNTRIES IN 2005 (11 PERCENT OF THOSE IN NEED)TO 920,000 CHILDREN ON TREATMENT GLOBALLY TODAY. IN 2016, CHAICONTINUED THIS WORK WITH PARTNERS TO EXPAND HIV TESTING, INCREASEACCESS TO QUALITY CARE, AND SCALE UP PROVEN INTERVENTIONS TO PREVENTDISEASE TRANSMISSION. CHAI HELPED SEVERAL COUNTRIES ADOPT NEWGUIDELINES FROM THE WORLD HEALTH ORGANIZATION (WHO) TO INITIATE
42,122,250. 6,556,492.129,662,635.
SEE SCHEDULE O FOR CONTINUATION(S)
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 2
632003 11-11-16
Yes No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
1
2
3
4
5
6
7
8
9
10
Section 501(c)(3) organizations.
a
b
c
d
e
f
a
b
11a
11b
11c
11d
11e
11f
12a
12b
13
14a
14b
15
16
17
18
19
a
b
If "Yes," complete Schedule ASchedule B, Schedule of Contributors
If "Yes," complete Schedule C, Part I
If "Yes," complete Schedule C, Part II
If "Yes," complete Schedule C, Part III
If "Yes," complete Schedule D, Part I
If "Yes," complete Schedule D, Part IIIf "Yes," complete
Schedule D, Part III
If "Yes," complete Schedule D, Part IV
If "Yes," complete Schedule D, Part V
If "Yes," complete Schedule D,Part VI
If "Yes," complete Schedule D, Part VII
If "Yes," complete Schedule D, Part VIII
If "Yes," complete Schedule D, Part IXIf "Yes," complete Schedule D, Part X
If "Yes," complete Schedule D, Part XIf "Yes," complete
Schedule D, Parts XI and XII
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optionalIf "Yes," complete Schedule E
If "Yes," complete Schedule F, Parts I and IV
If "Yes," complete Schedule F, Parts II and IV
If "Yes," complete Schedule F, Parts III and IV
If "Yes," complete Schedule G, Part I
If "Yes," complete Schedule G, Part IIIf "Yes,"
complete Schedule G, Part III
Form 990 (2016) Page
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization required to complete ?
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office?
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
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?
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures?
Did the organization maintain collections of works of art, historical treasures, or other similar assets?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
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.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16?
Did the organization report an amount for other liabilities in Part X, line 25?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~
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)?
Did the organization obtain separate, independent audited financial statements for the tax year?
~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization included in consolidated, independent audited financial statements for the tax year?
~~~~~
Is the organization a school described in section 170(b)(1)(A)(ii)?
Did the organization maintain an office, employees, or agents outside of the United States?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
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 11e? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
�����������������������������������������������
Form (2016)
3Part IV Checklist of Required Schedules
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
XX
X
X
X
X
X
X
X
X
X
X
X
XX
X
X
XX
X
X
X
X
X
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 3
632004 11-11-16
Yes No
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
a
b
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
a
b
c
d
a
b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations.
a
b
c
a
b
Section 501(c)(3) organizations.
Note.
(continued)
If "Yes," complete Schedule H
If "Yes," complete Schedule I, Parts I and II
If "Yes," complete Schedule I, Parts I and III
If "Yes," completeSchedule J
If "Yes," answer lines 24b through 24d and completeSchedule K. If "No", go to line 25a
If "Yes," complete Schedule L, Part I
If "Yes," completeSchedule L, Part I
If "Yes,"complete Schedule L, Part II
If "Yes," complete Schedule L, Part III
If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IVIf "Yes," complete Schedule M
If "Yes," complete Schedule M
If "Yes," complete Schedule N, Part IIf "Yes," complete
Schedule N, Part II
If "Yes," complete Schedule R, Part IIf "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part VI
Form 990 (2016) Page
Did the organization operate one or more hospital facilities? ~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
Did the organization engage in an excess benefit
transaction with a disqualified person during the year?
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?
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 current or former officer, director, trustee, or key employee? ~~~~~~~~~~~
A family member of a current or former officer, director, trustee, or key employee?
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?
~~
~~~~~~~~~~~~~~~~~~~~~
Did the organization receive more than $25,000 in non-cash contributions?
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions?
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization liquidate, terminate, or dissolve and cease operations?
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3?
Was the organization related to any tax-exempt or taxable entity?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
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)?
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~
Did the organization make any transfers to an exempt non-charitable related organization?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
All Form 990 filers are required to complete Schedule O �������������������������������
Form (2016)
4Part IV Checklist of Required Schedules
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
X
X
X
X
X
X
X
X
XX
XX
X
X
X
X
XX
X
X
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 4
632005 11-11-16
Yes No
1
2
3
4
5
6
7
a
b
c
1a
1b
1c
a
b
2a
Note.
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
7g
7h
8
9a
9b
a
b
a
b
a
b
c
a
b
Organizations that may receive deductible contributions under section 170(c).
a
b
c
d
e
f
g
h
7d
8
9
10
11
12
13
14
Sponsoring organizations maintaining donor advised funds.
Sponsoring organizations maintaining donor advised funds.
a
b
Section 501(c)(7) organizations.
a
b
10a
10b
Section 501(c)(12) organizations.
a
b
11a
11b
a
b
Section 4947(a)(1) non-exempt charitable trusts. 12a
12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
Note.
a
b
c
a
b
13a
13b
13c
14a
14b
e-file
If "No," to line 3b, provide an explanation in Schedule O
If "No," provide an explanation in Schedule O
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?
Form (2016)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part V ���������������������������
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners? �������������������������������������������
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 ~~~~~~~~~~
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
If the sum of lines 1a and 2a is greater than 250, you may be required to (see instructions)
~~~~~~~~~~
~~~~~~~~~~~
Did the organization have unrelated business gross income of $1,000 or more during the year?
If "Yes," has it filed a Form 990-T for this year?
~~~~~~~~~~~~~~
~~~~~~~~~~
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)?~~~~~~~
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
~~~~~~~~~~~~
~~~~~~~~~
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
~~~~~~~~~~~~~~~
����������������������������������������������������
If "Yes," indicate the number of Forms 8282 filed during the year
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
~~~~~~~~~~~~~~~~
~~~~~~~
~~~~~~~~~Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
~
Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year? ~~~~~~~~~~~~~~~~~~~
Did the sponsoring organization make any taxable distributions under section 4966?
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Enter:
Initiation fees and capital contributions included on Part VIII, line 12
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
~~~~~~~~~~~~~~~
~~~~~~
Enter:
Gross income from members or shareholders
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year ������
Is the organization licensed to issue qualified health plans in more than one state?
See the instructions for additional information the organization must report on Schedule O.
~~~~~~~~~~~~~~~~~~~~~
Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans
Enter the amount of reserves on hand
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization receive any payments for indoor tanning services during the tax year?
If "Yes," has it filed a Form 720 to report these payments?
~~~~~~~~~~~~~~~~
����������
5Part V Statements Regarding Other IRS Filings and Tax Compliance
990
J
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
440
X
350X
X
XSEE SCHEDULE O
XX
X
X
X
XX
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 5
632006 11-11-16
Yes No
1a
1b
1
2
3
4
5
6
7
8
9
a
b
2
3
4
5
6
7a
7b
8a
8b
9
a
b
a
b
Yes No
10
11
a
b
10a
10b
11a
12a
12b
12c
13
14
15a
15b
16a
16b
a
b
12a
b
c
13
14
15
a
b
16a
b
17
18
19
20
For each "Yes" response to lines 2 through 7b below, and for a "No" responseto line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
If "Yes," provide the names and addresses in Schedule O(This Section B requests information about policies not required by the Internal Revenue Code.)
If "No," go to line 13
If "Yes," describein Schedule O how this was done
(explain in Schedule O)
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 O.
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
Form (2016)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part VI ���������������������������
Enter the number of voting members of the governing body at the end of the tax year
Enter the number of voting members included in line 1a, above, who are independent
~~~~~~
~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
Did the organization become aware during the year of a significant diversion of the organization's assets?
Did the organization have members or stockholders?
~~~~~
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The governing body?
Each committee with authority to act on behalf of the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
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? �����������������
Did the organization have local chapters, branches, or affiliates?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~
~~~~~~
Did the organization regularly and consistently monitor and enforce compliance with the policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a written whistleblower policy?
Did the organization have a written document retention and destruction policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
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?
The organization's CEO, Executive Director, or top management official
Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ������������������������������������
List the states with which a copy of this Form 990 is required to be filed
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.
Own website Another's website Upon request Other
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: |
6Part VI Governance, Management, and Disclosure
Section A. Governing Body and Management
Section B. Policies
Section C. Disclosure
990
J
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
9
7
X
XXX
X
X
X
XX
X
X
XX
XX
XXX
XX
X
AR,CA,CT,FL,IL,MA,NJ,NY,PA,RI
X X X
PALESA MOHASOA - 617-774-0110383 DORCHESTER AVENUE, #400, BOSTON, MA 02127
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 6
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Key
empl
oyee
Hig
hest
com
pens
ated
empl
oyee
Form
er
(do not check more than onebox, unless person is both anofficer and a director/trustee)
632007 11-11-16
current
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a
current
current
former
former directors or trustees
(A) (B) (C) (D) (E) (F)
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part VII ���������������������������
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 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 key employees, if any. See instructions for definition of "key employee."¥ List the organization's five 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 officers, key employees, and highest compensated employees who received more than $100,000 ofreportable compensation from the organization and any related organizations.
¥ List all of the organization's 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.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
PositionName and Title Average hours per
week (list any
hours forrelated
organizationsbelowline)
Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
Form (2016)
7Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
(1) WILLIAM J. CLINTON 5.00CHAIR OF THE BOARD 20.00 X 0. 0. 0.(2) BRUCE LINDSEY 5.00BOARD MEMBER 45.00 X 0. 361,308. 42,384.(3) PAUL FARMER 1.00BOARD MEMBER 0.00 X 0. 0. 0.(4) RAYMOND CHAMBERS 1.00BOARD MEMBER 0.00 X 0. 0. 0.(5) CHELSEA CLINTON 10.00BOARD MEMBER 25.00 X 0. 0. 0.(6) MAGGIE WILLIAMS 1.00BOARD MEMBER 0.00 X 0. 0. 0.(7) MALA GAONKAR 1.00BOARD MEMBER 0.00 X 0. 0. 0.(8) TACHI YAMADA 1.00BOARD MEMBER 0.00 X 0. 0. 0.(9) IRA MAGAZINER 50.00CEO/VICE-CHAIR OF THE BOARD 0.00 X X 405,406. 0. 20,260.(10) JULIE B. FEDER 50.00CFO 0.00 X 289,721. 0. 33,883.(11) MUSTAPHA LEAVENWORTH BAKALI 50.00COO 0.00 X 269,683. 0. 15,689.(12) OWENS WIWA 50.00EVP, COUNTRY DIRECTOR 0.00 X 336,600. 0. 30,377.(13) KELLY MCCRYSTAL 50.00EVP, NEW INITIATIVES 0.00 X 220,000. 0. 18,619.(14) DAVID RIPIN 50.00EVP, ACCESS PROGRAMS 0.00 X 218,000. 0. 38,015.(15) ALICE KANG'ETHE 50.00EVP, VACCINE DEL./MATERNAL 0.00 X 220,000. 0. 5,910.(16) COLLEEN CONNELL 50.00VP, ACCESS DISEASE STRATEGY 0.00 X 179,769. 0. 21,832.(17) CORRIE MARTIN 50.00VP, GLOBAL OPERATIONS 0.00 X 190,312. 0. 31,042.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 7
Form
er
Indi
vidu
al tr
uste
e or
dire
ctor
Inst
itutio
nal t
rust
ee
Offi
cer
Hig
hest
com
pens
ated
empl
oyee
Key
empl
oyee
(do not check more than onebox, unless person is both anofficer and a director/trustee)
632008 11-11-16
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(B) (C)(A) (D) (E) (F)
1b
c
d
Sub-total
Total from continuation sheets to Part VII, Section A
Total (add lines 1b and 1c)
2
Yes No
3
4
5
former
3
4
5
Section B. Independent Contractors
1
(A) (B) (C)
2
(continued)
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such person
Page Form 990 (2016)
PositionAverage hours per
week(list any
hours forrelated
organizationsbelowline)
Name and title Reportablecompensation
from the
organization(W-2/1099-MISC)
Reportablecompensationfrom related
organizations(W-2/1099-MISC)
Estimatedamount of
othercompensation
from theorganizationand related
organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
~~~~~~~~~~ |
������������������������ |
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 officer, director, or trustee, key employee, or highest compensated employee on
line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? ������������������������
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.
Name and business address Description of services Compensation
Total number of independent contractors (including but not limited to those listed above) who received more than
$100,000 of compensation from the organization |
Form (2016)
8Part VII
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
(18) GEOFFREY WEBER 50.00CHIEF TECHNOLOGY OFFICER 0.00 X 180,000. 0. 962.(19) YOUNG (JOSHUA) CHU 50.00VP, GLOBAL VACCINCES & SE ASIA 0.00 X 161,000. 0. 13,473.(20) MPHU RAMATLAPENG 50.00EVP, HIV/AIDS & TB PROGRAM 0.00 X 159,999. 0. 3,382.(21) GERALD MACHARIA 50.00EVP, COUNTRY DIRECTOR 0.00 X 160,000. 0. 9,003.(22) ELYA TAGAR 50.00SENIOR DIRECTOR, HIV PROGRAMS 0.00 X 166,765. 0. 27,100.(23) JUSTIN COHEN 50.00DIRECTOR, GLOBAL MALARIA 0.00 X 160,250. 0. 28,752.(24) PAUL DOMANICO 50.00SR. DIRECTOR, RESEARCH & DEVELOPMENT 0.00 X 160,092. 0. 35,455.(25) ALAN STAPLE 50.00DIRECTOR, ACCESS GNT 0.00 X 160,000. 0. 28,383.(26) VISHAL BRIJLAL 50.00COUNTRY DIRECTOR 0.00 X 221,429. 0. 0.
3,859,026. 361,308. 404,521.0. 0. 0.
3,859,026. 361,308. 404,521.
91
X
X
X
GLOBAL HUMAN ACCESS RESOURCES, LTD, 1-2 SBBLOCK ESTATE MANAGEMENT OFFICE COMPLEX,
PROFESSIONALHEALTHCARE SERVICES 1,138,024.
AKENA ASSOCIATES, 16 IGHODARO STREET,EVBOMORE, BENIN CITY, NIGERIA
PROFESSIONALHEALTHCARE SERVICES 276,716.
PRACTICAL SAMPLING INTERNATIONAL, 118B,BISI OBADINA ST, OMOLE PHASE 1, LAGOS,
PROFESSIONALHEALTHCARE SERVICES 237,605.
LUIS MIGUEL PEREZ ROJASLOS CIPRESES N63-19, QUITO, ECUADOR
PROFESSIONALHEALTHCARE SERVICES 163,243.
FIELD INTELLIGENCE, LLC, NO. 4 ADZOPECRESCENT WUSE II, ADUJA, FCT, NIGERIA
PROFESSIONALHEALTHCARE SERVICES 143,704.
9
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 8
Noncash contributions included in lines 1a-1f: $
632009 11-11-16
Total revenue.
(A) (B) (C) (D)
1 a
b
c
d
e
f
g
h
1
1
1
1
1
1
a
b
c
d
e
f
Co
ntr
ibu
tio
ns
, G
ifts
, G
ran
tsa
nd
Oth
er
Sim
ila
r A
mo
un
ts
Total.
Business Code
a
b
c
d
e
f
g
2
Pro
gra
m S
erv
ice
Re
ven
ue
Total.
3
4
5
6 a
b
c
d
a
b
c
d
7
a
b
c
8
a
b
9 a
b
c
a
b
10 a
b
c
a
b
Business Code
11 a
b
c
d
e Total.
Oth
er
Re
ven
ue
12
Revenue excludedfrom tax under
sections512 - 514
All other contributions, gifts, grants, and
similar amounts not included above
See instructions.
Form (2016)
Page Form 990 (2016)
Check if Schedule O contains a response or note to any line in this Part VIII �������������������������
Total revenue Related orexempt function
revenue
Unrelatedbusinessrevenue
Federated campaigns
Membership dues
~~~~~~
~~~~~~~~
Fundraising events
Related organizations
~~~~~~~~
~~~~~~
Government grants (contributions)
~~
Add lines 1a-1f ����������������� |
All other program service revenue ~~~~~
Add lines 2a-2f ����������������� |
Investment income (including dividends, interest, and
other similar amounts)
Income from investment of tax-exempt bond proceeds
~~~~~~~~~~~~~~~~~ |
|
Royalties ����������������������� |
(i) Real (ii) Personal
Gross rents
Less: rental expenses
Rental income or (loss)
Net rental income or (loss)
~~~~~~~
~~~
~~
�������������� |
Gross amount from sales of
assets other than inventory
(i) Securities (ii) Other
Less: cost or other basis
and sales expenses
Gain or (loss)
~~~
~~~~~~~
Net gain or (loss) ������������������� |
Gross income from fundraising events (not
including $ of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~
Less: direct expenses~~~~~~~~~~
Net income or (loss) from fundraising events ����� |
Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~
Less: direct expenses
Net income or (loss) from gaming activities
~~~~~~~~~
������ |
Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~
Less: cost of goods sold
Net income or (loss) from sales of inventory
~~~~~~~~
������ |
Miscellaneous Revenue
All other revenue ~~~~~~~~~~~~~
Add lines 11a-11d ~~~~~~~~~~~~~~~ |
|�������������
9Part VIII Statement of Revenue
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
65,539,690.
77,209,450.301,147.
142,749,140.
88,986. 88,986.
2,980,609. 559.
2,877,937. 0.102,672. 559.
103,231. 103,231.
MISC. REVENUE 900099 11,901. 11,901.
11,901.142,953,258. 0. 0. 204,118.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 9
Check here if following SOP 98-2 (ASC 958-720)
632010 11-11-16
Total functional expenses.
Joint costs.
(A) (B) (C) (D)
1
2
3
4
5
6
7
8
9
10
11
a
b
c
d
e
f
g
12
13
14
15
16
17
18
19
20
21
22
23
24
a
b
c
d
e
25
26
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Professional fundraising services. See Part IV, line 17
(If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.)
Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line24e amount exceeds 10% of line 25, column (A)amount, list line 24e expenses on Schedule O.)
Add lines 1 through 24e
Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part IX ��������������������������
Total expenses Program serviceexpenses
Management andgeneral expenses
Fundraisingexpenses
~
Grants and other assistance to domestic
individuals. See Part IV, line 22 ~~~~~~~
Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16 ~~~
Benefits paid to or for members ~~~~~~~
Compensation of current officers, directors,
trustees, and key employees ~~~~~~~~
~~~
Other salaries and wages ~~~~~~~~~~
Other employee benefits ~~~~~~~~~~
Payroll taxes ~~~~~~~~~~~~~~~~
Fees for services (non-employees):
Management
Legal
Accounting
Lobbying
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Investment management fees
Other.
~~~~~~~~
Advertising and promotion
Office expenses
Information technology
Royalties
~~~~~~~~~
~~~~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Occupancy ~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~Travel
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings ~~
Interest
Payments to affiliates
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Depreciation, depletion, and amortization
Insurance
~~
~~~~~~~~~~~~~~~~~
All other expenses
|
Form (2016)
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
10Part IX Statement of Functional Expenses
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
2,312,723. 2,312,723.
10,055,694. 10,055,694.
3,620,389. 2,942,052. 678,337.
52,029,561. 47,061,428. 4,281,166. 686,967.
2,661,452. 2,412,502. 215,238. 33,712.11,626,356. 10,473,521. 1,028,773. 124,062.3,019,572. 2,647,270. 317,554. 54,748.
390,548. 221,114. 169,434.480,558. 205,667. 274,891.
60,000. 60,000.
7,061,481. 6,601,272. 460,209.
2,038,619. 1,694,978. 340,028. 3,613.
2,147,891. 1,798,064. 349,326. 501.21,013,305. 20,581,454. 376,844. 55,007.
3,036,237. 2,960,445. 75,323. 469.
84,756. 47,485. 37,271.348,958. 219,901. 129,042. 15.
DIRECT PROGRAM EXPENSE 12,160,776. 12,160,726. 50.TELEPHONE 2,055,337. 1,882,997. 161,642. 10,698.CAPITAL CHARGES 1,811,500. 1,703,593. 103,930. 3,977.PROCUREMENT & SHIPPING 1,102,356. 1,102,356. 0. 0.
795,291. 577,393. 216,605. 1,293.139,913,360.129,662,635. 9,215,663. 1,035,062.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 10
632011 11-11-16
(A) (B)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
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
26
a
b
10a
10b
As
se
ts
Total assets.
Lia
bil
itie
s
Total liabilities.
Organizations that follow SFAS 117 (ASC 958), check here and
complete lines 27 through 29, and lines 33 and 34.
27
28
29
Organizations that do not follow SFAS 117 (ASC 958), check here
and complete lines 30 through 34.
30
31
32
33
34
Ne
t A
ss
ets
or
Fu
nd
Ba
lan
ce
s
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part X �����������������������������
Beginning of year End of year
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
~~~
~~~~~~
Investments - publicly traded securities
Investments - other securities. See Part IV, line 11
Investments - program-related. See Part IV, line 11
Intangible assets
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~
Add lines 1 through 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 of Schedule D
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~
Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~
Secured mortgages and notes payable to unrelated third parties ~~~~~~
Unsecured notes and loans payable to unrelated third parties ~~~~~~~~
Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X of
Schedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 17 through 25 ������������������
|
Unrestricted net assets
Temporarily restricted net assets
Permanently restricted net assets
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
|
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund
Retained earnings, endowment, accumulated income, or other funds
~~~~~~~~~~~~~~~
~~~~~~~~
~~~~
Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~
Total liabilities and net assets/fund balances ����������������
Form (2016)
11Balance SheetPart X
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
9,913,010. 2,231,644.4,964,111. 8,922,406.1,436,659. 410,922.
1,006,320. 6,049,344.
2,271,432.2,024,103. 224,506. 247,329.
367,118. 301,147.
77,325,560. 72,601,687.95,237,284. 90,764,479.6,096,991. 4,511,351.
29,206,904. 23,442,391.
374,687. 219,999.35,678,582. 28,173,741.
X
3,704,011. 2,621,616.55,854,691. 59,969,122.
59,558,702. 62,590,738.95,237,284. 90,764,479.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 11
632012 11-11-16
1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Yes No
1
2
3
a
b
c
2a
2b
2c
a
b
3a
3b
Form 990 (2016) Page
Check if Schedule O contains a response or note to any line in this Part XI ���������������������������
Total revenue (must equal Part VIII, column (A), line 12)
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other changes in net assets or fund balances (explain in Schedule O)
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
~~~~~~~~~~~~~~~~~~~
�����������������������������������������������
Check if Schedule O contains a response or note to any line in this Part XII ���������������������������
Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
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:
Separate basis Consolidated basis Both consolidated and separate basis
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:
Separate basis Consolidated basis Both consolidated and separate basis
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.
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 any steps taken to undergo such audits ����������������
Form (2016)
12Part XI Reconciliation of Net Assets
Part XII Financial Statements and Reporting
990
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
142,953,258.139,913,360.3,039,898.
59,558,702.-7,862.
0.
62,590,738.
X
X
X
X
X
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 12
(iv) Is the organization listedin your governing document?
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632021 09-21-16
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at
(i) (iii) (v) (vi)(ii) Name of supported
organization
Type of organization (described on lines 1-10 above (see instructions))
Amount of monetary
support (see instructions)
Amount of other
support (see instructions)
EIN
(Form 990 or 990-EZ)Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.| Attach to Form 990 or Form 990-EZ.
|
Open to PublicInspection
Name of the organization Employer identification number
1
2
3
4
5
6
7
8
9
10
11
12
section 170(b)(1)(A)(i).
section 170(b)(1)(A)(ii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iv).
section 170(b)(1)(A)(v).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(ix)
section 509(a)(2).
section 509(a)(4).
section 509(a)(1) section 509(a)(2) section 509(a)(3).
a
b
c
d
e
f
g
Type I.
You must complete Part IV, Sections A and B.
Type II.
You must complete Part IV, Sections A and C.
Type III functionally integrated.
You must complete Part IV, Sections A, D, and E.
Type III non-functionally integrated.
You must complete Part IV, Sections A and D, and Part V.
Yes No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2016
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
A church, convention of churches, or association of churches described in
A school described in (Attach Schedule E (Form 990 or 990-EZ).)
A hospital or a cooperative hospital service organization described in
A medical research organization operated in conjunction with a hospital described in Enter the hospital's name,
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
(Complete Part II.)
A federal, state, or local government or governmental unit described in
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
(Complete Part II.)
A community trust described in (Complete Part II.)
An agricultural research organization described in operated in conjunction with a land-grant college
or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or
university:
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 (Complete Part III.)
An organization organized and operated exclusively to test for public safety. See
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 or . See Check the box in
lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
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.
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).
A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions).
A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions).
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.
Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Provide the following information about the supported organization(s).
LHA
www.irs.gov/form990.
SCHEDULE A
Part I Reason for Public Charity Status
Public Charity Status and Public Support 2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 13
Subtract line 5 from line 4.
632022 09-21-16
Calendar year (or fiscal year beginning in)
Calendar year (or fiscal year beginning in) |
2
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
Total.
6 Public support.
(a) (b) (c) (d) (e) (f)
7
8
9
10
11
12
13
Total support.
12
First five years.
stop here
14
15
14
15
16
17
18
a
b
a
b
33 1/3% support test - 2016.
stop here.
33 1/3% support test - 2015.
stop here.
10% -facts-and-circumstances test - 2016.
stop here.
10% -facts-and-circumstances test - 2015.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2016
|
Add lines 7 through 10
Schedule A (Form 990 or 990-EZ) 2016 Page
(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 III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
2012 2013 2014 2015 2016 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
Add lines 1 through 3 ~~~
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) ~~~~~~~~~~~~
2012 2013 2014 2015 2016 Total
Amounts from line 4 ~~~~~~~
Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
Net income from unrelated business
activities, whether or not the
business is regularly carried on ~
Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part VI.) ~~~~
Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~
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 ��������������������������������������������� |
~~~~~~~~~~~~Public support percentage for 2016 (line 6, column (f) divided by line 11, column (f))
Public support percentage from 2015 Schedule A, Part II, line 14
%
%~~~~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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 The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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 Explain in Part VI how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
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 Explain in Part VI how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ��� |
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
88,448,655. 117,270,913. 141,533,835. 170,688,566. 142,749,140. 660,691,109.
88,448,655. 117,270,913. 141,533,835. 170,688,566. 142,749,140. 660,691,109.
401,712,419.258,978,690.
88,448,655. 117,270,913. 141,533,835. 170,688,566. 142,749,140. 660,691,109.
91,498. 95,183. 133,981. 98,827. 88,986. 508,475.
148,563. 38,717. 13,714. 47,352. 11,901. 260,247.661,459,831.
39.1540.37
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 14
(Subtract line 7c from line 6.)
Amounts included on lines 2 and 3 received
from other than disqualified persons that
exceed the greater of $5,000 or 1% of the
amount on line 13 for the year
(Add lines 9, 10c, 11, and 12.)
632023 09-21-16
Calendar year (or fiscal year beginning in) |
Calendar year (or fiscal year beginning in) |
Total support.
3
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
6
7
Total.
a
b
c
8 Public support.
(a) (b) (c) (d) (e) (f)
9
10a
b
c11
12
13
14 First five years.
stop here
15
16
15
16
17
18
19
20
2016
2015
17
18
a
b
33 1/3% support tests - 2016.
stop here.
33 1/3% support tests - 2015.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2016
Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975
Schedule A (Form 990 or 990-EZ) 2016 Page
(Complete only if you checked the box on line 10 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.)
2012 2013 2014 2015 2016 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
Gross receipts from admissions,merchandise sold or services per-formed, or facilities furnished inany activity that is related to theorganization's tax-exempt purpose
Gross receipts from activities that
are not an unrelated trade or bus-
iness under section 513 ~~~~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
~~~ Add lines 1 through 5
Amounts included on lines 1, 2, and
3 received from disqualified persons
~~~~~~
Add lines 7a and 7b ~~~~~~~
2012 2013 2014 2015 2016 Total
Amounts from line 6 ~~~~~~~Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~
~~~~
Add lines 10a and 10b ~~~~~~Net income from unrelated businessactivities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~Other income. Do not include gainor loss from the sale of capitalassets (Explain in Part VI.) ~~~~
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 ���������������������������������������������������� |
Public support percentage for 2016 (line 8, column (f) divided by line 13, column (f))
Public support percentage from 2015 Schedule A, Part III, line 15
~~~~~~~~~~~~ %
%��������������������
Investment income percentage for (line 10c, column (f) divided by line 13, column (f))
Investment income percentage from Schedule A, Part III, line 17
~~~~~~~~ %
%~~~~~~~~~~~~~~~~~~
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 The organization qualifies as a publicly supported organization ~~~~~~~~~~ |
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 The organization qualifies as a publicly supported organization~~~~ |
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions �������� |
Part III Support Schedule for Organizations Described in Section 509(a)(2)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
Section D. Computation of Investment Income Percentage
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 15
632024 09-21-16
4
Yes No
1
2
3
4
5
6
7
8
9
10
1
2
3a
3b
3c
4a
4b
4c
5a
5b
5c
6
7
8
9a
9b
9c
10a
10b
a
b
c
a
b
c
a
b
c
a
b
c
a
b
Type I or Type II only.
Substitutions only.
Schedule A (Form 990 or 990-EZ) 2016
If "No," describe in how the supported organizations are designated. If designated byclass or purpose, describe the designation. If historic and continuing relationship, explain.
If "Yes," explain in how the organization determined that the supportedorganization was described in section 509(a)(1) or (2).
If "Yes," answer(b) and (c) below.
If "Yes," describe in when and how theorganization made the determination.
If "Yes," explain in what controls the organization put in place to ensure such use.If
"Yes," and if you checked 12a or 12b in Part I, answer (b) and (c) below.
If "Yes," describe in how the organization had such control and discretiondespite being controlled or supervised by or in connection with its supported organizations.
If "Yes," explain in what controls the organization usedto ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)purposes.
If "Yes,"answer (b) and (c) below (if applicable). Also, provide detail in including (i) the names and EINnumbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;(iii) the authority under the organization's organizing document authorizing such action; and (iv) how the actionwas accomplished (such as by amendment to the organizing document).
If "Yes," provide detail in
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," answer 10b below.(Use Schedule C, Form 4720, to
determine whether the organization had excess business holdings.)
Schedule A (Form 990 or 990-EZ) 2016 Page
(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Are all of the organization's supported organizations listed by name in the organization's governing
documents?
Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)?
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)?
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)?
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)
purposes?
Was any supported organization not organized in the United States ("foreign supported organization")?
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization?
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)?
Did the organization add, substitute, or remove any supported organizations during the tax year?
Was any added or substituted supported organization part of a class already
designated in the organization's organizing document?
Was the substitution the result of an event beyond the organization's control?
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?
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor
(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with
regard to a substantial contributor?
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
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))?
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?
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?
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)?
Did the organization have any excess business holdings in the tax year?
Part VI
Part VI
Part VI
Part VI
Part VI
Part VI
Part VI,
Part VI.
Part VI.
Part VI.
Part VI.
Part IV Supporting Organizations
Section A. All Supporting Organizations
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 16
632025 09-21-16
5
Yes No
11
a
b
c
11a
11b
11c
Yes No
1
2
1
2
Yes No
1
1
Yes No
1
2
3
1
2
3
1
2
3
a
b
c
Yes No
a
b
a
b
2a
2b
3a
3b
Schedule A (Form 990 or 990-EZ) 2016
If "Yes" to a, b, or c, provide detail in
If "No," describe in how the supported organization(s) effectively operated, supervised, orcontrolled 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 supportedorganizations and what conditions or restrictions, if any, applied to such powers during the tax year.
If "Yes," explain in how providing such benefit carried out the purposes of the supported organization(s) that operated,
supervised, or controlled the supporting organization.
If "No," describe in how controlor management of the supporting organization was vested in the same persons that controlled or managedthe supported organization(s).
If "No," explain in howthe organization maintained a close and continuous working relationship with the supported organization(s).
If "Yes," describe in the role the organization'ssupported organizations played in this regard.
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year Complete below.
Complete below.Describe in Part VI how you supported a government entity (see instructions).
If "Yes," then in how these activities directly furthered their exempt purposes,
how the organization was responsive to those supported organizations, and how the organization determinedthat these activities constituted substantially all of its activities.
If "Yes," explain in thereasons for the organization's position that its supported organization(s) would have engaged in theseactivities but for the organization's involvement.
Provide details in
If "Yes," describe in the role played by the organization in this regard.
Schedule A (Form 990 or 990-EZ) 2016 Page
Has the organization accepted a gift or contribution from any of the following persons?
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?
A family member of a person described in (a) above?
A 35% controlled entity of a person described in (a) or (b) above?
Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the
tax year?
Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization?
Were a majority of the organization's directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization's supported organization(s)?
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?
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?
The organization satisfied the Activities Test.
The organization is the parent of each of its supported organizations.
The organization supported a governmental entity.
Activities Test.
Did substantially all of the organization's activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive?
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?
Parent of Supported Organizations.
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?
Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each
of its supported organizations?
Part VI.
Part VI
Part VI
Part VI
Part VI
Part VI
(see instructions).
line 2
line 3
Answer (a) and (b) below.
Part VI identify
those supported organizations and explain
Part VI
Answer (a) and (b) below.
Part VI.
Part VI
(continued)Part IV Supporting Organizations
Section B. Type I Supporting Organizations
Section C. Type II Supporting Organizations
Section D. All Type III Supporting Organizations
Section E. Type III Functionally Integrated Supporting Organizations
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 17
632026 09-21-16
6
1 See instructions.
Section A - Adjusted Net Income
1
2
3
4
5
6
7
8
1
2
3
4
5
6
7
8Adjusted Net Income
Section B - Minimum Asset Amount
1
2
3
4
5
6
7
8
a
b
c
d
e
1a
1b
1c
1d
2
3
4
5
6
7
8
Total
Discount
Part VI
Minimum Asset Amount
Section C - Distributable Amount
1
2
3
4
5
6
7
1
2
3
4
5
6
Distributable Amount.
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI.) All
other Type III non-functionally integrated supporting organizations must complete Sections A through E.
(B) Current Year(optional)(A) Prior Year
Net short-term capital gain
Recoveries of prior-year distributions
Other gross income (see instructions)
Add lines 1 through 3
Depreciation and depletion
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)
Other expenses (see instructions)
(subtract lines 5, 6, and 7 from line 4)
(B) Current Year(optional)(A) Prior Year
Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
Average monthly value of securities
Average monthly cash balances
Fair market value of other non-exempt-use assets
(add lines 1a, 1b, and 1c)
claimed for blockage or other
factors (explain in detail in ):
Acquisition indebtedness applicable to non-exempt-use assets
Subtract line 2 from line 1d
Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,
see instructions)
Net value of non-exempt-use assets (subtract line 4 from line 3)
Multiply line 5 by .035
Recoveries of prior-year distributions
(add line 7 to line 6)
Current Year
Adjusted net income for prior year (from Section A, line 8, Column A)
Enter 85% of line 1
Minimum asset amount for prior year (from Section B, line 8, Column A)
Enter greater of line 2 or line 3
Income tax imposed in prior year
Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions)
Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see
instructions).
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 18
632027 09-21-16
7
Section D - Distributions Current Year
1
2
3
4
5
6
7
8
9
10
Part VI
Total annual distributions.
Part VI
(i)
Excess Distributions
(ii)Underdistributions
Pre-2016
(iii)Distributable
Amount for 2016Section E - Distribution Allocations (see instructions)
1
2
3
4
5
6
7
8
a
b
c
d
e
f
g
h
i
j
Total
a
b
c
Excess distributions carryover to 2017.
a
b
c
d
e
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
Amounts paid to supported organizations to accomplish exempt purposes
Amounts paid to perform activity that directly furthers exempt purposes of supported
organizations, in excess of income from activity
Administrative expenses paid to accomplish exempt purposes of supported organizations
Amounts paid to acquire exempt-use assets
Qualified set-aside amounts (prior IRS approval required)
Other distributions (describe in ). See instructions
Add lines 1 through 6
Distributions to attentive supported organizations to which the organization is responsive
(provide details in ). See instructions
Distributable amount for 2016 from Section C, line 6
Line 8 amount divided by Line 9 amount
Distributable amount for 2016 from Section C, line 6
Underdistributions, if any, for years prior to 2016 (reason-
able cause required- explain in Part VI). See instructions
Excess distributions carryover, if any, to 2016:
From 2013
From 2014
From 2015
of lines 3a through e
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Carryover from 2011 not applied (see instructions)
Remainder. Subtract lines 3g, 3h, and 3i from 3f.
Distributions for 2016 from Section D,
line 7: $
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Remainder. Subtract lines 4a and 4b from 4
Remaining underdistributions for years prior to 2016, if
any. Subtract lines 3g and 4a from line 2. For result greater
than zero, explain in Part VI. See instructions
Remaining underdistributions for 2016. Subtract lines 3h
and 4b from line 1. For result greater than zero, explain in
Part VI. See instructions
Add lines 3j
and 4c
Breakdown of line 7:
Excess from 2013
Excess from 2014
Excess from 2015
Excess from 2016
(continued) Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 19
632028 09-21-16
8
Schedule A (Form 990 or 990-EZ) 2016
Schedule A (Form 990 or 990-EZ) 2016 Page
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 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V,Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information.(See instructions.)
Part VI Supplemental Information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 20
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
623451 10-18-16
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(Form 990, 990-EZ,or 990-PF)
| 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 .
Name of the organization Employer identification number
Organization type
Filers of: Section:
not
General Rule Special Rule.
Note:
General Rule
Special Rules
(1) (2)
General Rule
Caution:
must
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
exclusively
exclusively exclusively
nonexclusively
(check one):
Form 990 or 990-EZ 501(c)( ) (enter number) organization
4947(a)(1) nonexempt charitable trust treated as a private foundation
527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the or a
Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
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.
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 $5,000 or 2% of the amount on (i) Form 990, Part VIII, line 1h,
or (ii) Form 990-EZ, line 1. Complete Parts I and II.
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 for religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
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 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 religious, charitable, etc.,
purpose. Don't complete any of the parts unless the applies to this organization because it received
religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~ | $
An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF),
but it 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 doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA
www.irs.gov/form990
Schedule B Schedule of Contributors
2016
** PUBLIC DISCLOSURE COPY **
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X 3
X
623452 10-18-16
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
(See instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
2
Part I Contributors
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
1 X
47,855,670.
2 X
22,175,450.
3 X
13,138,299.
4 X
9,599,563.
5 X
6,738,191.
6 X
6,526,298.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 22
623452 10-18-16
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
(See instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
$
(Complete Part II fornoncash contributions.)
2
Part I Contributors
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
7 X
3,704,333.
8 X
3,186,084.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 23
623453 10-18-16
Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(See instructions)
(b)
Description of noncash property given
(d)
Date received
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
(See instructions). Use duplicate copies of Part II if additional space is needed.
$
$
$
$
$
$
3
Part II Noncash Property
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 24
(Enter this info. once.)
For organizations
completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year.
623454 10-18-16
Name of organization Employer identification number
religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 forthe year from any one contributor. (a) (e) and
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
Complete columns through the following line entry.
Schedule B (Form 990, 990-EZ, or 990-PF) (2016) Page
| $
Use duplicate copies of Part III if additional space is needed.
Exclusively
4
Part III
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 25
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632051 08-29-16
Held at the End of the Tax Year
(Form 990) | 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
Open to PublicInspection
Name of the organization Employer identification number
(a) (b)
1
2
3
4
5
6
Yes No
Yes No
1
2
3
4
5
6
7
8
9
a
b
c
d
2a
2b
2c
2d
Yes No
Yes No
1
2
a
b
(i)
(ii)
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2016
Complete if the
organization answered "Yes" on Form 990, Part IV, line 6.
Donor advised funds Funds and other accounts
Total number at end of year
Aggregate value of contributions to (during year)
Aggregate value of grants from (during year)
Aggregate value at end of year
~~~~~~~~~~~~~~~
~~~~
~~~~~~
~~~~~~~~~~~~~
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control?~~~~~~~~~~~~~~~~~~
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? ��������������������������������������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
Protection of natural habitat
Preservation of open space
Preservation of a historically important land area
Preservation of a certified historic structure
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year.
Total number of conservation easements
Total acreage restricted by conservation easements
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements on a certified historic structure included in (a)
Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register
~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 |
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
|
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
| $
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)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
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.
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:
Revenue included on Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
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:
Revenue included on Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
$����������������������������������� |
LHA
www.irs.gov/form990.
Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Part II Conservation Easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
SCHEDULE D Supplemental Financial Statements 2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 26
632052 08-29-16
3
4
5
a
b
c
d
e
Yes No
1
2
a
b
c
d
e
f
a
b
Yes No
1c
1d
1e
1f
Yes No
(a) (b) (c) (d) (e)
1
2
3
4
a
b
c
d
e
f
g
a
b
c
a
b
Yes No
(i)
(ii)
3a(i)
3a(ii)
3b
(a) (b) (c) (d)
1a
b
c
d
e
Total.
Schedule D (Form 990) 2016
(continued)
(Column (d) must equal Form 990, Part X, column (B), line 10c.)
Two years back Three years back Four years back
Schedule D (Form 990) 2016 Page
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):
Public exhibition
Scholarly research
Preservation for future generations
Loan or exchange programs
Other
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
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? ������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 9, orreported an amount on Form 990, Part X, line 21.
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X?
If "Yes," explain the arrangement in Part XIII and complete the following table:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amount
Beginning balance
Additions during the year
Distributions during the year
Ending balance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII
~~~~~
�������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
Current year Prior year
Beginning of year balance
Contributions
Net investment earnings, gains, and losses
Grants or scholarships
~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~
Other expenditures for facilities
and programs
Administrative expenses
End of year balance
~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment
Permanent endowment
Temporarily restricted endowment
The percentages on lines 2a, 2b, and 2c should equal 100%.
| %
| %
| %
Are there endowment funds not in the possession of the organization that are held and administered for the organization
by:
unrelated organizations
related organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R?
Describe in Part XIII the intended uses of the organization's endowment funds.
~~~~~~~~~~~~~~~~~~~~
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property Cost or otherbasis (investment)
Cost or otherbasis (other)
Accumulateddepreciation
Book value
Land
Buildings
Leasehold improvements
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Equipment
Other
~~~~~~~~~~~~~~~~~
��������������������
Add lines 1a through 1e. |�������������
2Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets
Part IV Escrow and Custodial Arrangements.
Part V Endowment Funds.
Part VI Land, Buildings, and Equipment.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
167,749. 164,134. 3,615.2,103,683. 1,859,969. 243,714.
247,329.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 27
(including name of security)
632053 08-29-16
Total.
Total.
(a) (b) (c)
(1)
(2)
(3)
(a) (b) (c)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(a) (b)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total.
(a) (b) 1.
Total.
2.
Schedule D (Form 990) 2016
(Column (b) must equal Form 990, Part X, col. (B) line 15.)
(Column (b) must equal Form 990, Part X, col. (B) line 25.)
Description of security or category
(Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
(Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Schedule D (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
Book value Method of valuation: Cost or end-of-year market value
Financial derivatives
Closely-held equity interests
Other
~~~~~~~~~~~~~~~
~~~~~~~~~~~
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.Description of investment Book value Method of valuation: Cost or end-of-year market value
Complete if the organization answered "Yes" on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
Description Book value
���������������������������� |
Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
Description of liability Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Federal income taxes
����� |
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
3Part VII Investments - Other Securities.
Part VIII Investments - Program Related.
Part IX Other Assets.
Part X Other Liabilities.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
ASSETS LIMITED AS TO USE FOR PROGRAMMATIC PURPOSES 72,601,687.
72,601,687.
ASSETS HELD FOR COMMODITIESPURCHASE 219,999.
219,999.
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 28
632054 08-29-16
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d 2e
32e 1
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d
2e 1
2e
3
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
Schedule D (Form 990) 2016
(This must equal Form 990, Part I, line 12.)
(This must equal Form 990, Part I, line 18.)
Schedule D (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Total revenue, gains, and other support per audited financial statements
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
~~~~~~~~~~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Recoveries of prior year grants
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total revenue. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
�����������������
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Total expenses and losses per audited financial statements
Amounts included on line 1 but not on Form 990, Part IX, line 25:
~~~~~~~~~~~~~~~~~~~~~~~~~~
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through
Subtract line from line
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total expenses. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
����������������
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a 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.
4Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Part XIII Supplemental Information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
143,847,488.
-7,862.902,092.
894,230.142,953,258.
0.142,953,258.
140,815,452.
902,092.
902,092.139,913,360.
0.139,913,360.
PART X, LINE 2:
CHAI ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A
"MORE LIKELY THAN NOT" THRESHOLD TO THE RECOGNITION OF THE TAX POSITIONS
BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER
SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR
POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE
UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILITY
ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN
TAX POSITIONS. CHAI HAS IDENTIFIED ITS TAX STATUS AS A TAX EXEMPT ENTITY
AS ITS ONLY SIGNIFICANT TAX POSITION AND HAS DETERMINED THAT SUCH TAX
POSITION DOES NOT RESULT IN AN UNCERTAINTY REQUIRING RECOGNITION. CHAI'S
U.S. FEDERAL AND STATE INCOME TAX RETURNS ARE GENERALLY OPEN FOR
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 29
632055 08-29-16
5
Schedule D (Form 990) 2016
(continued)Schedule D (Form 990) 2016 Page Part XIII Supplemental Information
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
EXAMINATION FOR THREE YEARS FOLLOWING THE EXTENDED DATE, IF ANY, OF FILING
THE RELATED RETURN. CHAI'S FOREIGN TAX RETURNS ARE SUBJECT TO EXAMINATION
BY GOVERNMENT AUTHORITIES UNDER APPLICABLE LOCAL LAW. CHAI IS NOT AWARE OF
ANY PENDING EXAMINATION BY ANY SUCH AUTHORITY.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 30
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632071 09-21-16
| Complete if the organization answered "Yes" on Form 990, Part IV, line 14b, 15, or 16.
| Attach to Form 990.
| Information about Schedule F (Form 990) and its instructions is at Open to Public Inspection
Employer identification number
1
2
3
For grantmakers.
Yes No
For grantmakers.
(a) (b) (c) (d) (e) (f)
3 a
b
c Totals
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule F (Form 990) 2016
Name of the organization
Complete if the organization answered "Yes" on
Form 990, Part IV, line 14b.
Does the organization maintain records to substantiate the amount of its grants and other assistance,
the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance? ~~
Describe in Part V the organization's procedures for monitoring the use of its grants and other assistance outside the
United States.
Activities per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
Region Number ofoffices
in the region
Number ofemployees,agents, andindependentcontractorsin the region
Activities conducted in the region(by type) (such as, fundraising, pro-
gram services, investments, grants torecipients located in the region)
If activity listed in (d)is a program service,
describe specific typeof service(s) in the region
Totalexpenditures
for andinvestmentsin the region
Sub-total ~~~~~~
Total from continuation
sheets to Part I ~~~
(add lines 3a
and 3b) ������
LHA
www.irs.gov/form990.
(Form 990)
Part I General Information on Activities Outside the United States.
SCHEDULE F Statement of Activities Outside the United States 2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
SUB-SAHARAN AFRICA 17 886 PROGRAM SERVICES HEALTH 94,041,382.
EAST ASIA AND THEPACIFIC 6 110 PROGRAM SERVICES HEALTH 7,566,756.
SOUTH ASIA 1 104 PROGRAM SERVICES HEALTH 7,953,861.
CENTRAL AMERICA ANDTHE CARIBBEAN 1 7 PROGRAM SERVICES HEALTH 1,348,940.
RUSSIA ANDNEIGHBORING STATES 1 5 PROGRAM SERVICES HEALTH 387,587.
EUROPE (INCLUDINGICELAND & GREENLAND) 0 17 PROGRAM SERVICES HEALTH 0.
NORTH AMERICA 0 7 PROGRAM SERVICES HEALTH 0.
SUB-SAHARAN AFRICA 0 0 GRANTS HEALTH 7,457,994.26 1136 118,756,520.
0 0 2,597,701.
26 1136 121,354,221.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 31
63218104-01-16
(a) (b) (c) (d) (e) (f)
Totals
Schedule F (Form 990) Page 1 (Schedule F (Form 990), Part I, line 3)
Region Number ofoffices
in the region
Number ofemployees or
agents inregion
Activities conducted in region(by type) (i.e., fundraising,
program services, grants torecipients located in the region)
If activity listed in (d)is a program service,
describe specific typeof service(s) in region
Totalexpenditures
for region
��������� |
Part I Continuation of Activities per Region.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
EAST ASIA AND THEPACIFIC 0 0 GRANTS HEALTH 480,232.
SOUTH ASIA 0 0 GRANTS HEALTH 1,629,670.
RUSSIA ANDNEIGHBORING STATES 0 0 GRANTS HEALTH 23,839.
EUROPE (INCLUDINGICELAND & GREENLAND) 0 0 GRANTS HEALTH 463,960.
2,597,701.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 32
632072 09-21-16
2
Part II Grants and Other Assistance to Organizations or Entities Outside the United States.
(a) (b)
(c) (d) (e) (f) (g) (h) (i) 1
2
3
Schedule F (Form 990) 2016
IRS code section
and EIN (if applicable)
Schedule F (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any
recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
Name of organization RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnoncash
assistance
Descriptionof noncashassistance
Method ofvaluation (book, FMV,
appraisal, other)
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by
the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ~~~~~~~~~~~~~~~~~~~~~~~ |
Enter total number of other organizations or entities ��������������������������������������������� |
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
EAST ASIA AND THEPACIFIC HEALTH 58,735. 0.
EAST ASIA AND THEPACIFIC HEALTH 50,000. 0.
EAST ASIA AND THEPACIFIC HEALTH 49,580. 0.
EAST ASIA AND THEPACIFIC HEALTH 49,008. 0.
EAST ASIA AND THEPACIFIC HEALTH 48,589. 0.
EAST ASIA AND THEPACIFIC HEALTH 42,595. 0.
EAST ASIA AND THEPACIFIC HEALTH 42,008. 0.
EAST ASIA AND THEPACIFIC HEALTH 38,747. 0.
0134
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
EAST ASIA AND THEPACIFIC HEALTH 20,200. 0.
EAST ASIA AND THEPACIFIC HEALTH 17,058. 0.
EAST ASIA AND THEPACIFIC HEALTH 12,893. 0.
EAST ASIA AND THEPACIFIC HEALTH 12,270. 0.
EAST ASIA AND THEPACIFIC HEALTH 11,897. 0.
EAST ASIA AND THEPACIFIC HEALTH 7,217. 0.
EAST ASIA AND THEPACIFIC HEALTH 6,429. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 10,835. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 6,303. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
34
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
RUSSIA AND THENEWLY INDEPENDENTSTATES HEALTH 20,104. 0.
SOUTH ASIA HEALTH 240,147. 0.
SOUTH ASIA HEALTH 229,423. 0.
SOUTH ASIA HEALTH 131,439. 0.
SOUTH ASIA HEALTH 106,518. 0.
SOUTH ASIA HEALTH 101,564. 0.
SOUTH ASIA HEALTH 95,820. 0.
SOUTH ASIA HEALTH 89,340. 0.
SOUTH ASIA HEALTH 74,580. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SOUTH ASIA HEALTH 72,794. 0.
SOUTH ASIA HEALTH 53,219. 0.
SOUTH ASIA HEALTH 49,209. 0.
SOUTH ASIA HEALTH 46,969. 0.
SOUTH ASIA HEALTH 43,400. 0.
SOUTH ASIA HEALTH 39,249. 0.
SOUTH ASIA HEALTH 36,285. 0.
SOUTH ASIA HEALTH 35,491. 0.
SOUTH ASIA HEALTH 32,972. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SOUTH ASIA HEALTH 29,864. 0.
SOUTH ASIA HEALTH 29,561. 0.
SOUTH ASIA HEALTH 26,664. 0.
SOUTH ASIA HEALTH 25,214. 0.
SOUTH ASIA HEALTH 11,342. 0.
SOUTH ASIA HEALTH 9,660. 0.
SOUTH ASIA HEALTH 7,459. 0.
SOUTH ASIA HEALTH 5,991. 0.
SUB-SAHARANAFRICA HEALTH 2,017,506. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 633,145. 0.
SUB-SAHARANAFRICA HEALTH 570,348. 0.
SUB-SAHARANAFRICA HEALTH 281,246. 0.
SUB-SAHARANAFRICA HEALTH 190,000. 0.
SUB-SAHARANAFRICA HEALTH 183,725. 0.
SUB-SAHARANAFRICA HEALTH 175,439. 0.
SUB-SAHARANAFRICA HEALTH 172,920. 0.
SUB-SAHARANAFRICA HEALTH 168,263. 0.
SUB-SAHARANAFRICA HEALTH 149,592. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 144,696. 0.
SUB-SAHARANAFRICA HEALTH 138,155. 0.
SUB-SAHARANAFRICA HEALTH 134,523. 0.
SUB-SAHARANAFRICA HEALTH 129,360. 0.
SUB-SAHARANAFRICA HEALTH 126,914. 0.
SUB-SAHARANAFRICA HEALTH 126,208. 0.
SUB-SAHARANAFRICA HEALTH 112,689. 0.
SUB-SAHARANAFRICA HEALTH 96,365. 0.
SUB-SAHARANAFRICA HEALTH 93,405. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
39
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 92,547. 0.
SUB-SAHARANAFRICA HEALTH 90,061. 0.
SUB-SAHARANAFRICA HEALTH 83,419. 0.
SUB-SAHARANAFRICA HEALTH 72,354. 0.
SUB-SAHARANAFRICA HEALTH 69,105. 0.
SUB-SAHARANAFRICA HEALTH 68,011. 0.
SUB-SAHARANAFRICA HEALTH 65,570. 0.
SUB-SAHARANAFRICA HEALTH 65,305. 0.
SUB-SAHARANAFRICA HEALTH 62,728. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
40
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 60,063. 0.
SUB-SAHARANAFRICA HEALTH 58,210. 0.
SUB-SAHARANAFRICA HEALTH 57,628. 0.
SUB-SAHARANAFRICA HEALTH 47,841. 0.
SUB-SAHARANAFRICA HEALTH 47,314. 0.
SUB-SAHARANAFRICA HEALTH 31,766. 0.
SUB-SAHARANAFRICA HEALTH 31,299. 0.
SUB-SAHARANAFRICA HEALTH 29,696. 0.
SUB-SAHARANAFRICA HEALTH 29,304. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
41
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 27,371. 0.
SUB-SAHARANAFRICA HEALTH 26,564. 0.
SUB-SAHARANAFRICA HEALTH 24,872. 0.
SUB-SAHARANAFRICA HEALTH 23,156. 0.
SUB-SAHARANAFRICA HEALTH 22,930. 0.
SUB-SAHARANAFRICA HEALTH 22,281. 0.
SUB-SAHARANAFRICA HEALTH 21,325. 0.
SUB-SAHARANAFRICA HEALTH 20,716. 0.
SUB-SAHARANAFRICA HEALTH 20,232. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
42
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 20,144. 0.
SUB-SAHARANAFRICA HEALTH 20,108. 0.
SUB-SAHARANAFRICA HEALTH 18,090. 0.
SUB-SAHARANAFRICA HEALTH 17,537. 0.
SUB-SAHARANAFRICA HEALTH 17,500. 0.
SUB-SAHARANAFRICA HEALTH 16,768. 0.
SUB-SAHARANAFRICA HEALTH 16,098. 0.
SUB-SAHARANAFRICA HEALTH 14,840. 0.
SUB-SAHARANAFRICA HEALTH 14,707. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
43
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 14,589. 0.
SUB-SAHARANAFRICA HEALTH 14,354. 0.
SUB-SAHARANAFRICA HEALTH 13,565. 0.
SUB-SAHARANAFRICA HEALTH 12,618. 0.
SUB-SAHARANAFRICA HEALTH 11,012. 0.
SUB-SAHARANAFRICA HEALTH 10,248. 0.
SUB-SAHARANAFRICA HEALTH 9,719. 0.
SUB-SAHARANAFRICA HEALTH 9,611. 0.
SUB-SAHARANAFRICA HEALTH 9,537. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
44
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 9,367. 0.
SUB-SAHARANAFRICA HEALTH 8,998. 0.
SUB-SAHARANAFRICA HEALTH 7,495. 0.
SUB-SAHARANAFRICA HEALTH 7,312. 0.
SUB-SAHARANAFRICA HEALTH 7,231. 0.
SUB-SAHARANAFRICA HEALTH 6,474. 0.
SUB-SAHARANAFRICA HEALTH 6,437. 0.
SUB-SAHARANAFRICA HEALTH 6,383. 0.
SUB-SAHARANAFRICA HEALTH 6,260. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
45
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 6,059. 0.
SUB-SAHARANAFRICA HEALTH 6,045. 0.
SUB-SAHARANAFRICA HEALTH 6,000. 0.
SUB-SAHARANAFRICA HEALTH 5,815. 0.
SUB-SAHARANAFRICA HEALTH 5,736. 0.
SUB-SAHARANAFRICA HEALTH 5,671. 0.
SUB-SAHARANAFRICA HEALTH 5,523. 0.
SUB-SAHARANAFRICA HEALTH 5,467. 0.
SUB-SAHARANAFRICA HEALTH 5,301. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
46
63218204-01-16
2
Part II
(a)
Continuation of Grants and Other Assistance to Organizations or Entities Outside the United States.
(b) (c)
(d) (e) (f) (g) (h) (i) 1 IRS code section
and EIN (if applicable)
Schedule F (Form 990) Page
Name of organization
(Schedule F (Form 990), Part II, line 1)
RegionPurpose of
grant
Amount
of cash grant
Manner of
cash disbursement
Amount ofnon-cash
assistance
Descriptionof non-cashassistance
Method ofvaluation (book, FMV,
appraisal, other)
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SUB-SAHARANAFRICA HEALTH 5,101. 0.
SUB-SAHARANAFRICA HEALTH 5,092. 0.
SUB-SAHARANAFRICA HEALTH 5,038. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 268,518. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 110,575. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 21,179. 0.
EUROPE (INCLUDINGICELAND ANDGREENLAND) HEALTH 17,210. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
47
632073 09-21-16
3
Part III Grants and Other Assistance to Individuals Outside the United States.
(c) (d) (e) (f) (g) (h) (a) (b)
Schedule F (Form 990) 2016
Schedule F (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
Number ofrecipients
Amount ofcash grant
Manner ofcash disbursement
Amount ofnoncash
assistance
Description ofnoncash assistance
Method ofvaluation
(book, FMV,appraisal, other)
Type of grant or assistance Region
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
48
632074 09-21-16
4
1
2
3
4
5
6
Schedule F (Form 990) 2016
If "Yes," theorganization may be required to file Form 926, Return by a U.S. Transferor of Property to a ForeignCorporation (see Instructions for Form 926)
If "Yes," the organizationmay be required to separately file Form 3520, Annual Return To Report Transactions With ForeignTrusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of ForeignTrust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)
If "Yes,"the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect ToCertain Foreign Corporations (see Instructions for Form 5471)
If "Yes," the organization may be required to file Form 8621,Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund(see Instructions for Form 8621)
If "Yes,"the organization may be required to file Form 8865, Return of U.S. Persons With Respect to CertainForeign Partnerships (see Instructions for Form 8865)
If"Yes," the organization may be required to separately file Form 5713, International Boycott Report (seeInstructions for Form 5713; do not file with Form 990)
Schedule F (Form 990) 2016 Page
Was the organization a U.S. transferor of property to a foreign corporation during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have an interest in a foreign trust during the tax year?
~~~~~~~~~~ Yes No
Did the organization have an ownership interest in a foreign corporation during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Was the organization a direct or indirect shareholder of a passive foreign investment company or a
qualified electing fund during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have an ownership interest in a foreign partnership during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Did the organization have any operations in or related to any boycotting countries during the tax year?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
Part IV Foreign Forms
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
X
X
X
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 49
632075 09-21-16
5
Schedule F (Form 990) 2016
Schedule F (Form 990) 2016 Page
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of
investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c)
(estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
Part V Supplemental Information
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
PART I, LINE 2:
FOR GRANTS OUSTIDE THE US, EACH COUNTRY OR PROGRAM TEAM REQUESTS THEIR
CASH NEEDS EACH MONTH FROM HEADQUARTERS AP. AFTER THESE AMOUNTS ARE
VERIFIED, THE HEADQUARTERS TEAM DISBURSES THE FUNDS TO THE
COUNTRY/PROGRAM TEAMS. AT THE END OF EACH MONTH THE EXPENSES FOR EACH
TEAM ARE REVIEWED TO SEE WHERE FUNDS WERE USED AND WHAT PROJECT CHARGED.
SCHEDULE F, PART II, LINE 3:
THE GRANTEES COUNTED ON LINE 3 CONSIST OF GOVERNMENT MINISTRIES OF
HEALTH, HOSPITALS, AND OTHER ORGANIZATIONS IN FURTHERANCE OF OUR
MISSION. MANY OF THE GRANTEES MAY BE RECOGNIZED AS CHARITIES WITHIN
THEIR LOCAL COUNTRY.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 50
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Didfundraiser
have custodyor control of
contributions?
632081 09-12-16
Information about Schedule G (Form 990 or 990-EZ) and its instructions is at
(Form 990 or 990-EZ)Complete if the organization answered "Yes" on Form 990, Part IV, line 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. Open to Public
Inspection| Employer identification number
1
a
b
c
d
a
b
e
f
g
2
Yes No
(i) (ii)
(iii) (iv)
(v)
(i)
(vi)
Yes No
Total
3
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2016
Name of the organization
Complete if the organization answered "Yes" on Form 990, Part IV, line 17. Form 990-EZ filers are notrequired to complete this part.
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
Mail solicitations
Internet and email solicitations
Phone solicitations
In-person solicitations
Solicitation of non-government grants
Solicitation of government grants
Special fundraising events
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?
If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be
compensated at least $5,000 by the organization.
Name and address of individualor entity (fundraiser)
ActivityGross receipts
from activity
Amount paidto (or retained by)
fundraiserlisted in col.
Amount paidto (or retained by)
organization
�������������������������������������� |
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registrationor licensing.
LHA
www.irs.gov/form990.
SCHEDULE GSupplemental Information Regarding Fundraising or Gaming Activities
Fundraising Activities. Part I
2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
XX XXX
X
THE HELEN BROWN GROUP LLC -48 SUMMER ST., SUITE 2, RESEARCH X 250,000. 60,000. 190,000.
250,000. 60,000. 190,000.
AR,CA,CT,FL,IL,NJ,NY,PA,RI,MA,WA
SEE PART IV FOR CONTINUATIONS
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 51
632082 09-12-16
2
(d)
(a)
(c)
(a) (b) (c)
1
2
3
4
5
6
7
8
9
10
11
(a) (b)
(c) (d)
(a) (c)
1
2
3
4
5
6
7
8
Yes Yes Yes
No No No
9
10
a
b
Yes No
a
b
Yes No
Schedule G (Form 990 or 990-EZ) 2016
Pull tabs/instantbingo/progressive bingo
Schedule G (Form 990 or 990-EZ) 2016 Page 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.
Total events
(add col. through
col. )
Re
ven
ue
Event #1 Event #2 Other events
(event type) (event type) (total number)
Gross receipts
Less: Contributions
~~~~~~~~~~~~~~
~~~~~~~~~~~
Gross income (line 1 minus line 2)
Dir
ec
t E
xpe
nse
s
����
Cash prizes
Noncash prizes
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Rent/facility costs ~~~~~~~~~~~~
Food and beverages
Entertainment
~~~~~~~~~~
~~~~~~~~~~~~~~
Other direct expenses ~~~~~~~~~~
Direct expense summary. Add lines 4 through 9 in column (d)
Net income summary. Subtract line 10 from line 3, column (d)
~~~~~~~~~~~~~~~~~~~~~~~~ |
������������������������ |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.
Re
ven
ue Bingo Other gaming
Total gaming (addcol. through col. )
Dir
ec
t E
xpe
nse
s
Gross revenue ��������������
Cash prizes
Noncash prizes
~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Rent/facility costs
Other direct expenses
~~~~~~~~~~~~
����������
% % %
Volunteer labor ~~~~~~~~~~~~~
Direct expense summary. Add lines 2 through 5 in column (d)
Net gaming income summary. Subtract line 7 from line 1, column (d)
~~~~~~~~~~~~~~~~~~~~~~~~ |
��������������������� |
Enter the state(s) in which the organization conducts gaming activities:
Is the organization licensed to conduct gaming activities in each of these states?
If "No," explain:
~~~~~~~~~~~~~~~~~~~~
Were any of the organization's gaming licenses revoked, suspended, or terminated during the tax year?
If "Yes," explain:
~~~~~~~~~
Part II Fundraising Events.
Part III Gaming.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 52
632083 09-12-16
3
11
12
13
14
15
Yes No
Yes No
a
b
13a
13b
Yes Noa
b
c
16
17
a
b
Yes No
Supplemental Information.
Schedule G (Form 990 or 990-EZ) 2016
Schedule G (Form 990 or 990-EZ) 2016 Page
Does the organization conduct gaming activities with nonmembers?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Indicate the percentage of gaming activity conducted in:
The organization's facility
An outside facility
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ %
%~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name |
Address |
Does the organization have a contract with a third party from whom the organization receives gaming revenue?
If "Yes," enter the amount of gaming revenue received by the organization |
~~~~~~
$ and the amount
of gaming revenue retained by the third party | $
If "Yes," enter name and address of the third party:
Name |
Address |
Gaming manager information:
Name |
Gaming manager compensation |
Description of services provided |
$
Director/officer Employee Independent contractor
Mandatory distributions:
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 | $
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
Part IV
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SCHEDULE G, PART I, LINE 2B, LIST OF TEN HIGHEST PAID FUNDRAISERS:
(I) NAME OF FUNDRAISER: THE HELEN BROWN GROUP LLC
(I) ADDRESS OF FUNDRAISER: 48 SUMMER ST., SUITE 2, WATERTOWN, MA 02472
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 53
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4
Schedule G (Form 990 or 990-EZ)
(continued)Schedule G (Form 990 or 990-EZ) Page
Part IV Supplemental Information
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 54
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
632101 11-01-16
SCHEDULE I(Form 990)
Complete if the organization answered "Yes" on Form 990, Part IV, line 21 or 22.
| Attach to Form 990.
| Information about Schedule I (Form 990) and its instructions is at
Open to PublicInspection
Employer identification number
General Information on Grants and AssistancePart I
1
2
Yes No
Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments.
(f) 1 (a) (b) (c) (d) (e) (g) (h)
2
3
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2016)
Name of the organization
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection
criteria used to award the grants or assistance? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any
recipient that received more than $5,000. Part II can be duplicated if additional space is needed.Method of
valuation (book,FMV, appraisal,
other)
Name and address of organizationor government
EIN IRC section(if applicable)
Amount ofcash grant
Amount ofnon-cash
assistance
Description ofnoncash assistance
Purpose of grantor assistance
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table
Enter total number of other organizations listed in the line 1 table
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
�������������������������������������������������� |
LHA
www.irs.gov/form990.
Grants and Other Assistance to Organizations,Governments, and Individuals in the United States 2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X
THOUGHTWORKS, INC.200 EAST RANDOLPH STREETCHICAGO, IL 60601 36-3888809 957,500. 0. HEALTH
FAMILY HEALTH INTERNATIONAL2224 E NC HWY 54DURHAM, NC 27713 23-7413005 501(C)(3) 229,926. 0. HEALTH
YALE UNIVERSITYP.O. BOX 1873NEW HAVEN, CT 06508 06-0646973 501(C)(3) 207,563. 0. HEALTH
MALARIA NO MORE FUND2341 EASTLAKE AVENUE EAST, SUITE 20SEATTLE, WA 98102 20-5664575 501(C)(3) 198,225. 0. HEALTH
JOHNS HOPKINS UNIVERSITY1101 E 33RD ST.BALTIMORE, MD 21211 52-0595110 501(C)(3) 189,800. 0. HEALTHTRUSTEES OF BOSTON UNIVERSITY DBABOSTON UNIVERSITY - 25 BUICKSTREET, 2ND FLOOR - BOSTON, MA02215 04-2103547 501(C)(3) 121,347. 0. HEALTH
12.10.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
55
63224104-01-16
Part II Continuation of Grants and Other Assistance to Governments and Organizations in the United States
(a) (b) (c) (d) (e) (f) (g) (h)
Schedule I (Form 990)
Schedule I (Form 990) Page 1
(Schedule I (Form 990), Part II.)
Name and address of organization or government
EIN IRC sectionif applicable
Amount of cash grant
Amount of non-cash
assistance
Method of valuation
(book, FMV, appraisal, other)
Description ofnon-cash assistance
Purpose of grantor assistance
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
BRIGHAM AND WOMEN'S PHYSICIANSORGANIZATION - P.O. BOX 3684 -BOSTON, MA 02241 04-2312909 501(C)(3) 120,000. 0. HEALTH
HOWARD UNIVERSITY2400 6TH ST., NWWASHINGTON, DC 20059 53-0204707 501(C)(3) 43,600. 0. HEALTH
STANLEY M. EPSTEIN313 HELMSDALE DRIVECHAPEL HILL, NC 27517 15-3349168 37,500. 0. HEALTH
OPTION2 DBA EDGEX LLC1830 EMBARCADERO 106OAKLAND, CA 94606 81-2178029 37,000. 0. HEALTH
TRUSTEES OF COLUMBIA UNIVERSITYP.O. BOX 29789NEW YORK, NY 10087 13-5598093 501(C)(3) 24,885. 0. HEALTHREGENTS OF UNIVERSITY OFCALIFORNIA - 3333 CALIFORNIASTREET, SUITE 315 - SAN FRANCISCO,CA 94143 94-6036493 501(C)(3) 24,000. 0. HEALTH
PATHFINDER INTERNATIONAL9 GALEN STREET, #217WATERTOWN, MA 02472 53-0235320 501(C)(3) 19,851. 0. HEALTH
STATOGEN CONSULTING, LLC3828 QUARRY ROADZEBULON, NC 27597-7518 20-5246842 19,375. 0. HEALTH
CHESAPEAKE RESEARCH REVIEW, LLC6940 COLUMBIA GATEWAY DRIVE, STE 11COLUMBIA, MD 21406 80-0876234 14,000. 0. HEALTH
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
56
63224104-01-16
Part II Continuation of Grants and Other Assistance to Governments and Organizations in the United States
(a) (b) (c) (d) (e) (f) (g) (h)
Schedule I (Form 990)
Schedule I (Form 990) Page 1
(Schedule I (Form 990), Part II.)
Name and address of organization or government
EIN IRC sectionif applicable
Amount of cash grant
Amount of non-cash
assistance
Method of valuation
(book, FMV, appraisal, other)
Description ofnon-cash assistance
Purpose of grantor assistance
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
INSTEDD955 BENECIA AVENUESUNNYVALE, CA 94085 20-4895174 501(C)(3) 12,269. 0. HEALTH
OPEN FUNCTION GROUP LLC66 EUCLID AVENUEHASTINGS-ON-HUDSON, NY 10706 47-3652099 10,000. 0. HEALTH
PRINCETON IN AFRICA194 NASSUA STREET, SUITE 219PRINCETON, NJ 08542 22-3824520 501(C)(3) 10,000. 0. HEALTH
CLINIPACE, INC.3800 PARAMOUNT PARKWAYMORRISVILLE, NC 27560 30-0266681 9,215. 0. HEALTH
THE BOSTON CONSULTING GROUP1 BEACON STREETBOSTON, MA 02108 04-2432614 9,167. 0. HEALTH
BOSTON MICROFLUIDICS40 HALL STREET, #2110MEDFORD, MA 02155 20-3259803 9,000. 0. HEALTH
ONA SYSTEMS INC.126 E 12TH ST., SUITE 4ANEW YORK, NY 10003-5320 38-3940780 8,500. 0. HEALTH
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
57
632102 11-01-16
2Part III Grants and Other Assistance to Domestic Individuals.
(e) (a) (b) (c) (d) (f)
Part IV Supplemental Information.
Schedule I (Form 990) (2016)
Schedule I (Form 990) (2016) Page Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
Method of valuation(book, FMV, appraisal, other)
Type of grant or assistance Number ofrecipients
Amount ofcash grant
Amount of non-cash assistance
Description of noncash assistance
Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
PART I, LINE 2:
FOR GRANTS INSIDE THE US, EACH COUNTRY OR PROGRAM TEAMS REQUESTS THEIR CASH
NEEDS EACH MONTH WITH AP. AFTER THESE AMOUNTS ARE VERIFED, THE
HEADQUARTERS TEAM DISBURSES THE FUNDS TO THE COUNTRY/PROGRAM TEAMS. AT THE
END OF EACH MONTH, THE EXPENSES FOR EACH TEAM ARE REVIEWED TO SEE WHERE
FUNDS WERE USED AND WHAT PROJECT WAS CHARGED.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632111 09-09-16
For certain Officers, Directors, Trustees, Key Employees, and HighestCompensated Employees
Complete if the organization answered "Yes" on Form 990, Part IV, line 23.Open to Public
InspectionAttach to Form 990.
| Information about Schedule J (Form 990) and its instructions is at Employer identification number
Yes No
1a
b
1b
2
2
3
4
a
b
c
4a
4b
4c
Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
5a
5b
6a
6b
7
8
9
a
b
6
a
b
7
8
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2016
||
Name of the organization
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 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Travel for companions
Housing allowance or residence for personal use
Payments for business use of personal residence
Tax indemnification and gross-up payments
Discretionary spending account
Health or social club dues or initiation fees
Personal services (such as, maid, chauffeur, chef)
If any of the boxes on line 1a 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 III to explain~~~~~~~~~~~
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 on line 1a? ~~~~~~~~~~~~
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.
Compensation committee
Independent compensation consultant
Form 990 of other organizations
Written employment contract
Compensation survey or study
Approval by the board or compensation committee
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing
organization or a related organization:
Receive a severance payment or change-of-control payment?
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
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.
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the revenues of:
The organization?
Any related organization?
If "Yes" on line 5a or 5b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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:
The organization?
Any related organization?
If "Yes" on line 6a or 6b, describe in Part III.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed payments
not described on lines 5 and 6? If "Yes," describe in Part III
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
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958-6(c)? ���������������������������������������������
LHA
www.irs.gov/form990.
SCHEDULE J(Form 990)
Part I Questions Regarding Compensation
Compensation Information
2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X X
X
X
XXX
XXX
XX
XX
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 59
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2
Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Note:
(B) (C) (D) (E) (F)
(i) (ii) (iii) (A)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Use duplicate copies if additional space is needed.
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 aren't listed on Form 990, Part VII.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
Breakdown of W-2 and/or 1099-MISC compensation Retirement andother deferredcompensation
Nontaxablebenefits
Total of columns(B)(i)-(D)
Compensationin column (B)
reported as deferredon prior Form 990
Basecompensation
Bonus &incentive
compensation
Otherreportable
compensation
Name and Title
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
(1) BRUCE LINDSEY 0. 0. 0. 0. 0. 0. 0.BOARD MEMBER 361,230. 0. 78. 15,900. 26,484. 403,692. 0.(2) IRA MAGAZINER 405,406. 0. 0. 0. 20,260. 425,666. 0.CEO/VICE-CHAIR OF THE BOARD 0. 0. 0. 0. 0. 0. 0.(3) JULIE B. FEDER 289,721. 0. 0. 8,029. 25,854. 323,604. 0.CFO 0. 0. 0. 0. 0. 0. 0.(4) MUSTAPHA LEAVENWORTH BAKALI 269,683. 0. 0. 0. 15,689. 285,372. 0.COO 0. 0. 0. 0. 0. 0. 0.(5) OWENS WIWA 336,600. 0. 0. 14,688. 15,689. 366,977. 0.EVP, COUNTRY DIRECTOR 0. 0. 0. 0. 0. 0. 0.(6) KELLY MCCRYSTAL 220,000. 0. 0. 13,200. 5,419. 238,619. 0.EVP, NEW INITIATIVES 0. 0. 0. 0. 0. 0. 0.(7) DAVID RIPIN 218,000. 0. 0. 12,161. 25,854. 256,015. 0.EVP, ACCESS PROGRAMS 0. 0. 0. 0. 0. 0. 0.(8) ALICE KANG'ETHE 220,000. 0. 0. 0. 5,910. 225,910. 0.EVP, VACCINE DEL./MATERNAL 0. 0. 0. 0. 0. 0. 0.(9) COLLEEN CONNELL 179,769. 0. 0. 10,800. 11,032. 201,601. 0.VP, ACCESS DISEASE STRATEGY 0. 0. 0. 0. 0. 0. 0.(10) CORRIE MARTIN 190,312. 0. 0. 10,782. 20,260. 221,354. 0.VP, GLOBAL OPERATIONS 0. 0. 0. 0. 0. 0. 0.(11) GEOFFREY WEBER 180,000. 0. 0. 0. 962. 180,962. 0.CHIEF TECHNOLOGY OFFICER 0. 0. 0. 0. 0. 0. 0.(12) YOUNG (JOSHUA) CHU 161,000. 0. 0. 6,720. 6,753. 174,473. 0.VP, GLOBAL VACCINCES & SE ASIA 0. 0. 0. 0. 0. 0. 0.(13) MPHU RAMATLAPENG 159,999. 0. 0. 0. 3,382. 163,381. 0.EVP, HIV/AIDS & TB PROGRAM 0. 0. 0. 0. 0. 0. 0.(14) GERALD MACHARIA 160,000. 0. 0. 0. 9,003. 169,003. 0.EVP, COUNTRY DIRECTOR 0. 0. 0. 0. 0. 0. 0.(15) ELYA TAGAR 166,765. 0. 0. 6,901. 20,199. 193,865. 0.SENIOR DIRECTOR, HIV PROGRAMS 0. 0. 0. 0. 0. 0. 0.(16) JUSTIN COHEN 160,250. 0. 0. 8,492. 20,260. 189,002. 0.DIRECTOR, GLOBAL MALARIA 0. 0. 0. 0. 0. 0. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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632112 09-09-16
2
Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Note:
(B) (C) (D) (E) (F)
(i) (ii) (iii) (A)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Use duplicate copies if additional space is needed.
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 aren't listed on Form 990, Part VII.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
Breakdown of W-2 and/or 1099-MISC compensation Retirement andother deferredcompensation
Nontaxablebenefits
Total of columns(B)(i)-(D)
Compensationin column (B)
reported as deferredon prior Form 990
Basecompensation
Bonus &incentive
compensation
Otherreportable
compensation
Name and Title
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
(17) PAUL DOMANICO 160,092. 0. 0. 9,601. 25,854. 195,547. 0.SR. DIRECTOR, RESEARCH & DEVELOPMENT 0. 0. 0. 0. 0. 0. 0.(18) ALAN STAPLE 160,000. 0. 0. 8,123. 20,260. 188,383. 0.DIRECTOR, ACCESS GNT 0. 0. 0. 0. 0. 0. 0.(19) VISHAL BRIJLAL 221,429. 0. 0. 0. 0. 221,429. 0.COUNTRY DIRECTOR 0. 0. 0. 0. 0. 0. 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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3
Part III Supplemental Information
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016 Page
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
PART I, LINE 1A:
STAFF WHO ARE ENROLLED IN THE CHAI DOMESTIC MEDICAL PLAN ARE ELIGIBLE FOR
REIMBURSEMENT OF THEIR GYM MEMBERSHIP UP TO $250 PER CALENDAR YEAR. THE
REIMBURSEMENT IS TAXABLE INCOME.
CHAI APPLIES A 'GROSS UP' ON EDUCATIONAL ALLOWANCE PAYMENTS IN ORDER TO
ENSURE THAT THE EMPLOYEE RECEIVES THE FULL BENEFIT OF THE ALLOWANCE,
WITHOUT THE IMPACT OF TAXATION.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Open To PublicInspection
Attach to Form 990.
Information about Schedule M (Form 990) and its instructions is at Employer identification number
(a) (b) (c) (d)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
29
Yes No
30
31
32
33
a
b
30a
31
32a
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2016)
Name of the organization
Check ifapplicable
Number ofcontributions or
items contributed
Noncash contributionamounts reported on
Form 990, Part VIII, line 1g
Method of determiningnoncash contribution amounts
Art - Works of art
Art - Historical treasures
Art - Fractional interests
~~~~~~~~~~~~~
~~~~~~~~~
~~~~~~~~~~
Books and publications
Clothing and household goods
~~~~~~~~~~
~~~~~~
Cars and other vehicles
Boats and planes
Intellectual property
~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~
Securities - Publicly traded
Securities - Closely held stock
~~~~~~~~
~~~~~~~
Securities - Partnership, LLC, or
trust interests
Securities - Miscellaneous
~~~~~~~~~~~~~~
~~~~~~~~
Qualified conservation contribution -
Historic structures
Qualified conservation contribution - Other
~~~~~~~~~~~~
~
Real estate - Residential
Real estate - Commercial
Real estate - Other
~~~~~~~~~
~~~~~~~~~
~~~~~~~~~~~~
Collectibles
Food inventory
Drugs and medical supplies
Taxidermy
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~~~~~~~
Historical artifacts
Scientific specimens
Archeological artifacts
~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~
Other ( )
Other ( )
Other ( )
Other ( )
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ~~~~
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it
must hold for at least three years from the date of the initial contribution, and which isn't required to be used for
exempt purposes for the entire holding period? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," describe the arrangement in Part II.
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions? ~~~~~~
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," describe in Part II.
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
LHA
www.irs.gov/form990.
SCHEDULE M(Form 990)
Part I Types of Property
Noncash Contributions2016J
J J
JJJJ
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
X 2 301,147.FAIR MARKET VALUE
0
X
X
X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 63
632142 08-23-16
2
Schedule M (Form 990) (2016)
Schedule M (Form 990) (2016) Page
Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organizationis reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also completethis part for any additional information.
Part II Supplemental Information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
SCHEDULE M, PART I, COLUMN (B):
THE NUMBER SHOWN IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 64
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
632211 08-25-16
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.
| Attach to Form 990 or 990-EZ.|
(Form 990 or 990-EZ)
Open to PublicInspection
Employer identification number
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2016)
Name of the organization
LHA
www.irs.gov/form990.
SCHEDULE O Supplemental Information to Form 990 or 990-EZ 2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:
THE CLINTON HEALTH ACCESS INITIATIVE, INC. (CHAI) WAS FOUNDED IN 2002
WITH A TRANSFORMATIONAL GOAL: HELP SAVE THE LIVES OF MILLIONS OF PEOPLE
LIVING WITH HIV/AIDS IN THE DEVELOPING WORLD BY DRAMATICALLY SCALING UP
ANTIRETROVIRAL TREATMENT. CHAI PLAYED A LEADERSHIP ROLE, WORKING
ALONGSIDE GOVERNMENTS AND OTHER PARTNERS, TO LOWER THE COSTS OF
TREATMENT AND HELP BUILD THE IN-COUNTRY SYSTEMS NECESSARY TO PROVIDE
LIFESAVING TREATMENT TO MILLIONS OF PEOPLE. SINCE THEN, CHAI HAS
PURSUED SEVERAL SIMILARLY AMBITIOUS GOALS, FROM SCALING UP PEDIATRIC
AIDS TREATMENT, TO RAPIDLY ACCELERATING THE ROLLOUT OF NEW VACCINES, TO
REDUCING THE BURDEN OF DISEASES SUCH AS MALARIA, TUBERCULOSIS AND
HEPATITIS AND IMPROVING HEALTH OUTCOMES FOR MOTHERS AND CHILDREN.
TODAY, CHAI OPERATES IN 32 COUNTRIES ACROSS THE DEVELOPING WORLD AND
MORE THAN 70 COUNTRIES ARE ABLE TO ACCESS CHAI-NEGOTIATED PRICE
REDUCTIONS, VACCINES, MEDICAL DEVICES, AND DIAGNOSTICS.
FORM 990, PART I, LINE 5:
THE NUMBER REPORTED ON PART I, LINE 5 REFLECTS THE NUMBER OF PEOPLE
REPORTED ON FORM W-3. CHAI EMPLOYS 1,325 PEOPLE AROUND THE GLOBE.
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS:
CHILDBIRTH. IN 2016, TWO INDEPENDENT EXTERNAL EVALUATIONS DEMONSTRATED
THAT THE CHAI APPROACH, IN A TARGET AREA OF 10 MILLION PEOPLE IN
NORTHERN NIGERIA, CONTRIBUTED TO A SUSTAINED 37 PERCENT REDUCTION IN
MATERNAL MORTALITY, A 43 PERCENT REDUCTION IN NEONATAL MORTALITY AND A
15 PERCENT REDUCTION IN STILLBIRTHS WITHIN 12 MONTHS.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 65
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2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organizationCLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
FORM 990, PART III, LINE 4B, PROGRAM SERVICE ACCOMPLISHMENTS:
AND IMPROVE MANAGEMENT OF AVAILABLE RESOURCES.
FORM 990, PART III, LINE 4C, PROGRAM SERVICE ACCOMPLISHMENTS:
TREATMENT FOR ALL PEOPLE DIAGNOSED WITH HIV REGARDLESS OF DISEASE
PROGRESSION, HELPED IMPROVE ACCESS TO NEWER AND BETTER TREATMENT AND
PREVENTION OPTIONS, AND CONTINUED TO WORK WITH PARTNERS TO IMPROVE
ACCESS TO TESTING, PREVENTION AND TREATMENT FOR INFANTS AND CHILDREN.
FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:
VACCINES: IMMUNIZATION IS ONE OF THE MOST SUCCESSFUL AND COST-EFFECTIVE
METHODS OF PREVENTING DISEASE AND SAVING LIVES. EVEN SO, MILLIONS DIE
EACH YEAR FROM VACCINE-PREVENTABLE DISEASES DUE TO LACK OF ACCESS.
CHAI IS WORKING GLOBALLY TO ENSURE THAT VACCINES ARE AVAILABLE,
EFFECTIVE AND AFFORDABLE, WITH A SPECIAL FOCUS IN NINE LOW-INCOME
COUNTRIES THAT REPRESENT 47 MILLION BIRTHS EVERY YEAR, ONE-THIRD OF ALL
BIRTHS GLOBALLY. OVER THE PAST FIVE YEARS, PRICING NEGOTIATIONS
BROKERED BY CHAI HAVE SAVED THE GLOBAL COMMUNITY OVER US$800 MILLION IN
PROCUREMENT COSTS BY REDUCING VACCINE PRICES BY 45 PERCENT TO 67
PERCENT. CHAI HAS HELPED ACCELERATE THE INTRODUCTION OF NEW VACCINES,
INCREASED SPEED AND EFFICIENCY TO REACH TARGET COVERAGE, AND
STRENGTHENED NATIONAL IMMUNIZATION SYSTEMS. CHAI IS ALSO HELPING
COUNTRIES BUILD SYSTEMS THAT ENSURE VACCINES ARE AVAILABLE AND POTENT
AT THE POINT-OF-CARE BY WORKING WITH KEY STAKEHOLDERS INVOLVED IN
GLOBAL COLD CHAIN MARKETS, EQUIPMENT MANUFACTURERS AND PARTNER
GOVERNMENTS TO INTRODUCE SUSTAINABLE SOLUTIONS FOR THE STORAGE,
DISTRIBUTION AND MANAGEMENT OF VACCINES.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 66
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organizationCLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
EXPENSES $ 16,276,388. INCLUDING GRANTS OF $ 1,203,189. REVENUE $ 0.
HUMAN RESOURCES FOR HEALTH & HEALTH SYSTEMS: A SKILLED HEALTH WORKFORCE
IS CRITICAL TO ANY WELL-FUNCTIONING HEALTH SYSTEM, YET MANY LOW- AND
MIDDLE-INCOME COUNTRIES FACE CHRONIC HEALTH WORKFORCE SHORTAGES AND
LACK THE SYSTEMS NECESSARY TO RECRUIT, TRAIN, DEPLOY AND RETAIN HEALTH
WORKERS WHERE THEY ARE MOST NEEDED. IN 2016, CHAI CONTINUED ITS WORK
WITH GOVERNMENT PARTNERS TO ADDRESS HEALTH WORKFORCE SHORTAGES BY
IMPLEMENTING PROGRAMS THAT PROVIDE HIGH-QUALITY TRAINING TO PRIORITY
HEALTH WORKERS AND STRENGTHEN HUMAN RESOURCES FOR HEALTH (HRH)
DEPARTMENTS WITHIN MINISTRIES OF HEALTH.
EXPENSES $ 15,186,458. INCLUDING GRANTS OF $ 4,055,921. REVENUE $ 0.
MALARIA: MALARIA IS A LARGELY PREVENTABLE AND TREATABLE DISEASE, YET
EACH YEAR IT KILLS OVER 400,000 PEOPLE GLOBALLY-MOSTLY CHILDREN UNDER
FIVE YEARS OF AGE. CHAI BELIEVES THAT MALARIA ELIMINATION IS POSSIBLE
IN THE NEAR-TERM IN MANY REGIONS OF THE WORLD AND IS WORKING WITH
PARTNERS AROUND THE GLOBE TO ACHIEVE THIS GOAL BY SCALING UP PROVEN
INTERVENTIONS AND IMPROVING THE EFFECTIVENESS OF ANTI-MALARIA PROGRAMS.
THROUGHOUT 2016, CHAI CONTINUED ITS WORK IN ASIA, AFRICA AND THE
AMERICAS TO COMBAT THE DISEASE AND HELP COUNTRIES REACH THEIR
ELIMINATION GOALS THROUGH IMPROVED TESTING, TREATMENT AND TRANSMISSION
REDUCTION EFFORTS.
EXPENSES $ 10,134,748. INCLUDING GRANTS OF $ 1,297,369. REVENUE $ 0.
OTHER PROGRAM SERVICES
EXPENSES $ 524,656. INCLUDING GRANTS OF $ 13. REVENUE $ 0.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 67
632212 08-25-16
2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organizationCLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
FORM 990, PART V, LINE 4B, LIST OF FOREIGN COUNTRIES:
CAMBODIA, CAMEROON, ETHIOPIA, INDIA,
INDONESIA, KENYA, LESOTHO, LIBERIA,
MALAWI, MOZAMBIQUE, NIGERIA, PAPUA-NEW GUINEA,
RWANDA, SOUTH AFRICA, SWAZILAND, TANZANIA,
UKRAINE, UGANDA, VIETNAM, ZAMBIA,
ZIMBABWE, UNITED KINGDOM, LAOS, SIERRA LEONE,
BURMA
FORM 990, PART VI, SECTION A, LINE 2:
WILLIAM J. CLINTON AND CHELSEA CLINTON HAVE A PARENT/CHILD RELATIONSHIP.
BUSINESS RELATIONSHIP: BRUCE LINDSEY IS EMPLOYED BY THE BILL, HILLARY, AND
CHELSEA CLINTON FOUNDATION ("THE FOUNDATION"), WHERE BOTH WILLIAM J.
CLINTON AND CHELSEA CLINTON SERVE AS DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 6:
UNDER CHAI'S BYLAWS THE FOUNDATION HAS THE POWER TO DESIGNATE FIVE (5)
SUCCESSOR MEMBERS OF THE BOARD, TWO OF WHOM SHALL BE PRESIDENT WILLIAM J.
CLINTON, WHO SHALL SERVE AS DIRECTOR AND CHAIR OF THE BOARD UNTIL SUCH TIME
AS HE RESIGNS, DIES OR BECOMES INCAPACITATED, AND IRA C MAGAZINER, WHO
SHALL SERVE AS A DIRECTOR AND VICE CHAIR OF BOARD SO LONG AS HE REMAINS AN
EMPLOYEE OR CONSULTANT OF THE CORPORATION OR UNTIL SUCH TIME AS HE RESIGNS,
DIES OR BECOMES INCAPACITATED.
ON MARCH 7, 2017, CHAI AMENDED ITS BYLAWS TO ALTER ITS GOVERNANCE
STRUCTURE. PRIOR TO THAT DATE, THE FOUNDATION APPOINTED FIVE OF CHAI'S NINE
BOARD MEMBERS, WITH THE REMAINING BOARD MEMBERS BEING ELECTED BY THE BOARD
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 68
632212 08-25-16
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Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organizationCLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
AS A WHOLE. EFFECTIVE ON MARCH 7, 2017, THE BOARD WAS EXPANDED TO FIFTEEN
MEMBERS, ALL OF WHOM ARE ELECTED BY THE BOARD AS A WHOLE. CURRENTLY, THREE
OF THE FIFTEEN DIRECTORS ALSO SERVE ON THE FOUNDATION'S BOARD.
FORM 990, PART VI, SECTION A, LINE 7A:
UNDER CHAI'S BYLAWS THE FOUNDATION HAS THE POWER TO DESIGNATE FIVE (5)
SUCCESSOR MEMBERS OF THE BOARD, TWO OF WHOM SHALL BE PRESIDENT WILLIAM J.
CLINTON, WHO SHALL SERVE AS DIRECTOR AND CHAIR OF THE BOARD UNTIL SUCH TIME
AS HE RESIGNS, DIES OR BECOMES INCAPACITATED, AND IRA C MAGAZINER, WHO
SHALL SERVE AS A DIRECTOR AND VICE CHAIR OF BOARD SO LONG AS HE REMAINS AN
EMPLOYEE OR CONSULTANT OF THE CORPORATION OR UNTIL SUCH TIME AS HE RESIGNS,
DIES OR BECOMES INCAPACITATED.
ON MARCH 7, 2017, CHAI AMENDED ITS BYLAWS TO ALTER ITS GOVERNANCE
STRUCTURE. PRIOR TO THAT DATE, THE FOUNDATION APPOINTED FIVE OF CHAI'S NINE
BOARD MEMBERS, WITH THE REMAINING BOARD MEMBERS BEING ELECTED BY THE BOARD
AS A WHOLE. EFFECTIVE ON MARCH 7, 2017, THE BOARD WAS EXPANDED TO FIFTEEN
MEMBERS, ALL OF WHOM ARE ELECTED BY THE BOARD AS A WHOLE. CURRENTLY, THREE
OF THE FIFTEEN DIRECTORS ALSO SERVE ON THE FOUNDATION'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11B:
THE SENIOR ACCOUNTING MANAGER COLLECTS AND CONSOLIDATES THE INFORMATION
AFTER THE 2016 AUDIT IS COMPLETED. THE RETURN IS PREPARED BY OUR EXTERNAL
TAX ADVISOR. THE CFO REVIEWS THE FORM 990, WHICH IS SUBSEQUENTLY REVIEWED
BY THE AUDIT COMMITTEE. THE BOARD OF DIRECTORS WILL RECEIVE A COPY OF THE
990 VIA EMAIL PRIOR TO THE FILING OF THE 990.
FORM 990, PART VI, SECTION B, LINE 12C:
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 69
632212 08-25-16
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Employer identification number
Schedule O (Form 990 or 990-EZ) (2016)
Schedule O (Form 990 or 990-EZ) (2016) Page
Name of the organizationCLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
INTERESTED PERSONS MUST DISCLOSE ANY TRANSACTION OR ARRANGEMENT WHICH
RESULTS IN A CONFLICT OF INTEREST TO THE BOARD OR COMMITTEE OF WHICH THEY
ARE A MEMBER. THE BOARD MEETS, REVIEWS AND DISCUSSES ANY DISCLOSED
CONFLICT OF INTEREST. CHAI SHALL TAKE APPROPRIATE DISCIPLINARY ACTIONS, AS
DETERMINED BY THE BOARD, WITH RESPECT TO AN INTERESTED PERSON WHO HAS
VIOLATED THE CONFLICT OF INTEREST POLICY. THIS APPLIES TO DIRECTORS,
OFFICERS, KEY EMPLOYEES, OR COMMITTEE MEMBERS AND ALL OTHERS WHO ARE
PERMITTED TO VOTE AT BOARD OF DIRECTOR MEETINGS.
FORM 990, PART VI, SECTION B, LINE 15:
CEO, PRESIDENT & COO, AND CFO COMPENSATION WAS MOST RECENTLY DETERMINED AND
APPROVED BY THE BOARD OF DIRECTORS IN 2016.
FORM 990, PART VI, SECTION C, LINE 19:
THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE
PUBLIC UPON REQUEST.
FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES, LINE 7:
CHAI IS AN OPERATING CHARITY - MEANING THAT OUR PEOPLE ACTUALLY DO
PROGRAMMATIC WORK AND THEIR SALARIES ARE DIRECTLY FOR PROGRAM
IMPLEMENTATION. OUT OF THE TOTAL OF $52M, $47M IS DIRECTLY RELATED TO
PROGRAM; $4.2M IS FOR GENERAL MANAGEMENT AND $686K IS FOR FUNDRAISING.
FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES, LINE 17:
WHILE THE CLASSIFICATION IS "TRAVEL", THE TOTAL OF $21M INCLUDES $13.2M
FOR MEETINGS AND TRAINING AND $7.3M FOR TRAVEL, BOTH OF WHICH ARE
PRIMARILY FOR PROGRAM IMPLEMENTATION.
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 70
OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Section 512(b)(13)
controlled
entity?
632161 09-06-16
SCHEDULE R(Form 990) Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990. Open to PublicInspection| Information about Schedule R (Form 990) and its instructions is at
Employer identification number
Part I Identification of Disregarded Entities.
(a) (b) (c) (d) (e) (f)
Identification of Related Tax-Exempt Organizations. Part II
(a) (b) (c) (d) (e) (f) (g)
Yes No
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2016
|
|
Name of the organization
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
Name, address, and EIN (if applicable)of disregarded entity
Primary activity Legal domicile (state or
foreign country)
Total income End-of-year assets Direct controllingentity
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exemptorganizations during the tax year.
Name, address, and EINof related organization
Primary activity Legal domicile (state or
foreign country)
Exempt Codesection
Public charitystatus (if section
501(c)(3))
Direct controllingentity
LHA
www.irs.gov/form990.
Related Organizations and Unrelated Partnerships
2016
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
CLINTON HEALTH ACCESS INITIATIVE INDIA26 OKHLA INDUSTRIAL ESTATE PHASE III CLINTON HEALTH ACCESSNEW DELHI, INDIA HEALTH INDIA 8,779,964. 216,648.INITIATIVECLINTON HEALTH ACCESS INITIATIVE3RD FLOOR, TIMAU PLAZA, ARGWINGS KODHEK RD. CLINTON HEALTH ACCESSNAIROBI, KENYA HEALTH KENYA 4,203,510. 88,671.INITIATIVECLINTON HEALTH ACCESS INITIATIVEMAQALIKA, DR. PHORORO'S RESIDENCE CLINTON HEALTH ACCESSMASERU, LESOTHO HEALTH LESOTHO 1,493,060. 15,707.INITIATIVECLINTON HEALTH ACCESS INITIATIVE -98-1316363, 7, GANGES STREET, MAITAMA CLINTON HEALTH ACCESSDISTRICT ABUJA, NIGERIA HEALTH NIGERIA 15,758,202. 172,829.INITIATIVE
BILL, HILLARY & CHELSEA CLINTON FOUNDATION -31-1580204, 610 PRESIDENT CLINTON AVENUE.,2ND FLR., LITTLE ROCK, AR 72201 ECONOMIC DEVELOPMENT ARKANSAS 501(C)(3) LINE 7 N/A XWILLIAM J CLINTON FOUNDATION - UKACRE HOUSE 11-15LONDON, UNITED KINGDOM FUNDRAISING UNITED KINGDOM N/A N/A BHCC FDN XCLINTON FOUNDATION INSALINGSSTIFTELSEBIRGER JARLSGATAN 55STOCKHOLM, SWEDEN 11145 FUNDRAISING SWEDEN N/A N/A BHCC FDN X
SEE PART VII FOR CONTINUATIONS
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
71
63222104-01-16
Part I Continuation of Identification of Disregarded Entities
(a) (b) (c) (d) (e) (f)
Schedule R (Form 990)
Name, address, and EINof disregarded entity
Primary activity Legal domicile (state or
foreign country)
Total income End-of-year assets Direct controllingentity
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
CLINTON HEALTH ACCESS INITIATIVE-SOUTHAFRICA, 1166 FRANCIS BAARD STREET, BLOCK B, CLINTON HEALTH ACCESS1ST FL., PRETORIA, GAUTENG, SOUTH AFRICA HEALTH SOUTH AFRICA 3,548,480. 788,763.INITIATIVECLINTON HEALTH ACCESS INITIATIVE -98-1316357, MBABANE OFFICE PARK, BUILDING 1, CLINTON HEALTH ACCESS3RD FL., MBABANE, SWAZILAND HEALTH SWAZILAND 2,238,970. 13,433.INITIATIVE
CLINTON HEALTH ACCESS INITIATIVE UGANDA CLINTON HEALTH ACCESSLIMITED, P.O. BOX 33252, KAMPALA, UGANDA HEALTH UGANDA 4,536,096. 437,796.INITIATIVECLINTON FOUNDATION HIV/AIDS INITIATIVE, INC.- 98-1316375, GUSTAVO MEJIA RICANT AVE., CLINTON HEALTH ACCESSPIANTINI TOWER, SIXTH FLOOR, SANTA DOMINGO, HEALTH DOMINICAN REPUBLIC 0. 0.INITIATIVECLINTON HEALTH ACCESS INITIATIVESKYWAYS BUILDING, 3RD FLOOR, P.O. BOX 77277 CLINTON HEALTH ACCESSDAR ES SALAAM, TANZANIA HEALTH TANZANIA 3,505,717. 48,214.INITIATIVECLINTON HEALTH ACCESS INITIATIVE-BOTSWANAN/A CLINTON HEALTH ACCESSBOTSWANA HEALTH BOTSWANA 0. 0.INITIATIVECLINTON HEALTH ACCESS INITIATIVE-UKN/A CLINTON HEALTH ACCESSUNITED KINGDOM HEALTH UNITED KINGDOM 0. 0.INITIATIVECLINTON HEALTH ACCESS INITIATIVE RDCDE LA PAIX, GAL. PRES APP 22 NO. 1 CLINTON HEALTH ACCESSKINSHASA, CONGO (KINSHASA) HEALTH CONGO (KINSHASA) 381,012. 0.INITIATIVE
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
72
Disproportionate
allocations?
Legaldomicile(state orforeigncountry)
General ormanagingpartner?
Section512(b)(13)controlled
entity?
Legal domicile(state orforeigncountry)
632162 09-06-16
2
Identification of Related Organizations Taxable as a Partnership. Part III
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
Yes No Yes No
Identification of Related Organizations Taxable as a Corporation or Trust. Part IV
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Yes No
Schedule R (Form 990) 2016
Predominant income(related, unrelated,
excluded from tax undersections 512-514)
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a partnership during the tax year.
Name, address, and EINof related organization
Primary activity Direct controllingentity
Share of totalincome
Share ofend-of-year
assets
Code V-UBIamount in box20 of ScheduleK-1 (Form 1065)
Percentageownership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a corporation or trust during the tax year.
Name, address, and EINof related organization
Primary activity Direct controllingentity
Type of entity(C corp, S corp,
or trust)
Share of totalincome
Share ofend-of-year
assets
Percentageownership
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
HAITI DEVELOPMENT FUND LLC -45-3819678, 1271 AVE OFAMERICAS, NEW YORK, NY 10020 INVESTMENT DE N/A RELATED 0. 0. X N/A X .00%
ACCESO FUND LLC - 27-20751711271 AVE OF AMERICASNEW YORK, NY 10020 INVESTMENT DE N/A RELATED 0. 0. X N/A X .00%
ACCESO OFERTO LOCAL-PRODUCTOSCALLE EL MIRADOR Y 93 AVENIDA FRUIT & VEG EL ACCESOEL SALVADOR SUPPLY SALVADO WORLDWIDE RELATED 0. 0. X N/A X .00%
ACACIA DEVELOPMENT CO - 81-16752711271 AVENUE OF AMERICASNEW YORK, NY 10020 INVESTMENT DE BHCC FDN C CORP .00% XACCESO WORLDWIDE FUND INC. - 46-41609201271 AVENUE OF AMERICASNEW YORK, NY 10020 INVESTMENT DE BHCC FDN C CORP .00% XACCESO CASHEW ENTERPRISE LIMITEDOFFICE NO 201 ACCESOKOHINOOR PARADISE AROGYA, MAHARASHTRA, INDIA CASHEW PROCESSING INDIA WORLDWIDE C CORP .00% XRUAHA DEVELOPMENT COMPANY LIMITEDIMMMA HSE, PLOT NO. 357, UN RD PO BX 72484 ACACIA DEVLPUPANGA, DAR ES SA, TANZANIA FARMING TANZANIA CO C CORP .00% XCHAKIPI ACCESO SACALLE CASCANUECES MZ M2 ACCESSO FUNDLOTE 4 LIMA, PERU DISTRIBUTION OF GOODS PERU LLC C CORP .00% X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
73
Section512(b)(13)controlled
entity?
Legal domicile(state orforeigncountry)
63222404-01-16
Part IV Continuation of Identification of Related Organizations Taxable as a Corporation or Trust
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Yes No
Schedule R (Form 990)
Name, address, and EINof related organization
Primary activity Direct controllingentity
Type of entity(C corp, S corp,
or trust)
Share of totalincome
Share ofend-of-year
assets
Percentageownership
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
TUKULA FARMING COMPANY LTD.PO BOX 5133 REALY HOUSE ACACIA DEV.CHURCH HILL RD LIMBE, MALAWI FARMING MALAWI CORP C CORP .00% X
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
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632163 09-06-16
3
Part V Transactions With Related Organizations.
Note: Yes No
1
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
(i) (ii) (iii) (iv) 1a
1b
1c
1d
1e
1f
1g
1h
1i
1j
1k
1l
1m
1n
1o
1p
1q
1r
1s
2
(a) (b) (c) (d)
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
Receipt of interest, annuities, royalties, or rent from a controlled entity ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gift, grant, or capital contribution to related organization(s)
Gift, grant, or capital contribution from related organization(s)
Loans or loan guarantees to or for related organization(s)
Loans or loan guarantees by related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dividends from related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sale of assets to related organization(s)
Purchase of assets from related organization(s)
Exchange of assets with related organization(s)
Lease of facilities, equipment, or other assets to related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Lease of facilities, equipment, or other assets from related organization(s)
Performance of services or membership or fundraising solicitations for related organization(s)
Performance of services or membership or fundraising solicitations by related organization(s)
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sharing of paid employees with related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Reimbursement paid to related organization(s) for expenses
Reimbursement paid by related organization(s) for expenses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other transfer of cash or property to related organization(s)
Other transfer of cash or property from related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
��������������������������������������������������������
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
Name of related organization Transactiontype (a-s)
Amount involved Method of determining amount involved
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
XXXXX
XXXXX
XXX
XX
XX
XX
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
75
Are allpartners sec.
501(c)(3)orgs.?
Dispropor-tionate
allocations?
General ormanagingpartner?
632164 09-06-16
Yes No Yes No Yes N
4
Part VI Unrelated Organizations Taxable as a Partnership.
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
o
Schedule R (Form 990) 2016
Predominant income(related, unrelated,
excluded from tax undersections 512-514)
Code V-UBIamount in box 20of Schedule K-1
(Form 1065)
Schedule R (Form 990) 2016 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
Name, address, and EINof entity
Primary activity Legal domicile(state or foreign
country)
Share oftotal
income
Share ofend-of-year
assets
Percentageownership
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01
76
632165 09-06-16
5
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016 Page
Provide additional information for responses to questions on Schedule R. See instructions.
Part VII Supplemental Information.
CLINTON HEALTH ACCESS INITIATIVE, INC. 27-1414646
PART I, IDENTIFICATION OF DISREGARDED ENTITIES:
NAME, ADDRESS, AND EIN OF DISREGARDED ENTITY:
CLINTON FOUNDATION HIV/AIDS INITIATIVE, INC.
EIN: 98-1316375
GUSTAVO MEJIA RICANT AVE., PIANTINI TOWER, SIXTH FLOOR
SANTA DOMINGO, DOMINICAN REPUBLIC
16411113 756948 25760.001 2016.05000 CLINTON HEALTH ACCESS INITI 25760_01 77