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SK Chmber - Events 2025ORCHARD 2025 Lodging Tax Application Coversheet Organization Name: South Kitsap Chamber of Commerce Month/Time frame of Event or Operations: 2025 Event/Activity (check/complete all that apply) ❑ Tourism Promotion ® Operations (Event/Festival Title) ❑ Operations (Facility, Staffing, Other) Amount of Request $ 9810 Presenter & Title: Cody Clark - Executive Director Phone - (360)876-3505 Email - cody@portorchard.com ORCHARD 2025 Lodging Tax Application Applicant Acknowledgement Applicants accept the following conditions: Application Deadline — October 24, 2024, by 2PM Applications will be accepted by a -mail at cityclerkgportorchardwa.gov • Late applications will not be accepted • Responses to be limited to 3 pages, plus required attachments • Successful, eligible applicants may be contacted to schedule an interview with the Lodging Tax Advisory Committee — Please note date scheduled is Wednesday, October 30, 2024. If funded, the individual who has the authority to sign contracts and provide documents to the City of Port Orchard is requested to sign below, and to also acknowledge your responsibility to notify (enter who to notify and how) of any changes to your organization's contact information. Point of Contact Cody Clark Title Executive Director Signature �� r" Phone 3608763505 Email cody@portorchar 'OUSTA"I ORCHARD 2025 Lodging Tax Application Checklist Submittal Checklist Application Transmittal ❑ Checklist ❑ Applicant Acknowledgement Submitted by Thursday, October 24, 2024 by 2PM Responses*: ❑Marketing Plan ❑Financial Status ❑Reporting Requirements *Does not exceed 3 pages Attachments: ❑ Total LTAC Budget ❑ Up to 5 Examples of Marketing ❑ 2024 Year -To -Date Income Statement ❑ 2024 Year -To -Date Balance Sheet ❑ 2023 Income Statement ❑ 2023 Balance Sheet ❑ Most Recent Tax Return or Financial Statement from an independent source South Kitsap CHAMBER OF COMMERCE 0/22/2024 City LTAC Application — Events Marketing Plan: Promoting Business Encouraging Community Educating Members i. Explain your Marketing Plan to promote tourism in Port Orchard. Specify your audience. The South Kitsap Chamber of Commerce will employ a diverse range of marketing strategies to promote our events and attract visitors from outside the Kitsap community to Port Orchard. Our marketing efforts will include targeted radio campaigns, Spotify and Meta ads, along with other digital and traditional channels. For our upcoming Rocky Horror Picture Show event, we will expand our outreach by promoting at Crypticon, a well- known horror movie convention in Tacoma, further broadening our reach within the regional fan base. ii. Discuss how your marketing plan generates "heads in beds" (overnight stays) in Port Orchard and/or draws visitors from 50+ miles away. For each of these events, our goal is to attract attendees from outside the Kitsap area. We plan to market our preliminary Cornhole tournaments, the Rocky Horror Picture Show 50th Anniversary Celebration, and various partner events within a 50-100 mile radius. Our previous events have demonstrated success in drawing a diverse audience, including participants from out of county and out of state. Notably, our 2024 Cornhole event and Seagull Calling Contest attracted significant attention beyond the local community, further proving the potential to expand our reach. iii. What percent of your budget is marketing? What percentage of your request is marketing? Provide a summary of the types of marketing and include the total amount spent for each type that your organization uses. Approximately 27% of the requested budget in this application will be dedicated to comprehensive marketing initiatives. These funds will be used to implement a multi -channel promotional strategy, including digital advertising, social media campaigns, radio spots, and event -specific outreach efforts. This investment is essential for increasing event visibility, attracting a broader audience, and ensuring the success of our community -focused events by drawing attendees from both within and outside of Port Orchard. www.skchamnber.org 1180 Bethel Ave, Suite 120 360-876-3505 Port Orchard, WA South Kitsap CHAMBER OF COMMERCE Financial Status: Promoting Business Encouraging Community Educating Members I. Has your organization applied for funding through other sources? Will your organization be pursuing other funding in the future? And if no, why? The South Kitsap Chamber of Commerce has consistently applied for funding through Port Orchard City LTAC, which plays a crucial role in ensuring our events are of the highest quality. This support allows us to create engaging, well -organized experiences that benefit both local businesses and attendees. In addition to LTAC funding, we are actively pursuing sponsorships for each event to foster community involvement and increase local investment in our initiatives. These partnerships not only provide financial backing but also strengthen connections with the community, enhancing the overall success of our events. ii. If your organization collaborates with other organizations on tourism, how is this accomplished? What do you collaborate about? And is this done without duplicating another organizations efforts? In recent years, we have actively collaborated with various Destination Marketing Organizations (DMOs) such as the Kitsap Tourism Coalition and Visit Kitsap Peninsula to promote the events, businesses, and attractions that make our community unique. These partnerships have been instrumental in raising awareness and driving tourism, contributing to the economic vitality of South Kitsap. We remain committed to fostering and strengthening these relationships, recognizing their value in showcasing our region's assets and ensuring that we continue to be a key player in regional tourism efforts. iii. If your organization does sole marketing, are you currently considering opportunities for collaboration? iv. What is your organization doing to become financially sustainable? The South Kitsap Chamber of Commerce is actively seeking additional grant funding and sponsorship opportunities to enhance our events and deepen community engagement. By securing more diverse funding sources, we aim to create a greater sense of ownership and participation from local businesses and residents. These investments will not only elevate the scale and quality of our events but also foster stronger connections within the community, ensuring that our initiatives are both impactful and sustainable for the long term. V. If you received part of your requested funding, would your program or event be possible? The South Kitsap Chamber of Commerce remains committed to funding our programs and, if necessary, will seek additional sponsorships to support our events. A portion of the financial need outlined in this proposal will be addressed through sponsorship contributions, as reflected in the included budget. These partnerships will help us offset costs, ensuring that our events maintain their quality and reach while fostering greater community involvement and investment. www.skchamnber.org 360-876-3505 1180 Bethel Ave, Suite 120 Port Orchard, WA South Kitsap CHAMBER OF COMMERCE Reporting Status: Promoting Business Encouraging Community Educating Members i. How many visitors will your program or event bring to Port Orchard? ii. How many visitors will travel to Port Orchard and stay overnight? iii. How many visitors will travel 50 miles+ for the day or stay overnight? If from outside WA, indicate how many and from what States and/or Countries when possible. iv. What revenue is expected to be generated by your program or event? V. Please explain your methodology for collecting and/or estimating tourist data. The South Kitsap Chamber of Commerce aims to attract as many attendees as possible to our events, with a focus on bringing visitors from outside Port Orchard. We plan to implement a targeted advertising campaign within a 50- 100 mile radius to broaden our reach and draw regional interest. Our efforts are designed not only to generate additional revenue for the Chamber but also to boost the local economy by increasing business for hotels, Airbnbs, and local businesses, as many visitors will stay overnight in Port Orchard. To ensure the success and impact of our events, we will collect valuable data from multiple sources, including participants in our cornhole tournaments, advertising analytics, surveys of partner event attendees, and feedback from moviegoers. This data will help us refine our strategies and enhance future events. Cody Clark Executive Director South Kitsap Chamber of Commerce www.skchamnber.org 360-876-3505 1180 Bethel Ave, Suite 120 Port Orchard, WA SOUTH KITSAP CHAMBER OF COMMERCE LTAC Budget 2025 Approx Budget - Events Corn Hole Preliminary - Expenses Event License/Alcohol $ 60.00 Swag/Banners $ 2,000.00 Prize Money $ 1,200.00 Misc Supplies $ 100.00 New speaker (adding a second one) $ 200.00 Advertising (radio ad and spotify ad) $ 1,500.00 $ 5,060.00 Sponsorship $2,000 Rocky Horror Picture Show 50 year Celebration Rights to Rocky Horror Picture Show $ 1,500.00 Food $ 1,500.00 Projector/Screen Rental $ 1,000.00 Pop Corn Machine/supplies/snacks $ 500.00 Mobile Bar $ 1,500.00 Advertising (radio ad and spotify ad) $ 1,500.00 Space Rental $ 500.00 $ 8,000.00 Sponsorship $3,000 Partner Events (Seagull Calling Contest/Holiday on the bay) Prizes for Seagull Calling $ 250.00 Advertising $ 1,000.00 Supplies for both events $ 500.00 $ 1,750.00 SOUTH KITSAP CHAMBER OF COMMERCE ASSETS Current Assets Bank Accounts Braintree Checking Account General DNU Paypal Invest. Co. America Navigator Key Bank KYP- Pen Credit Union Money Market Accounts Capital Improvement - E. Jones Total Money Market Accounts PayPal Bank Petty Cash Square Total Bank Accounts Accounts Receivable Accounts Receivable Total Accounts Receivable Other Current Assets A/R Adjustment Account Inventory Asset Luncheon Revenue Receivable Payroll Corrections Payroll Refunds Prepaid Rent Short Term CD Undeposited Funds Total Other Current Assets Total Current Assets Fixed Assets Fixed Assets Accumulated Depreciation Fixed Assets Improvements Total Fixed Assets Total Fixed Assets Balance Sheet As of October 22, 2024 TOTAL 0.00 11,434.92 0.00 69,511.69 0.00 741.42 0.00 0.00 1,270.80 302.84 0.00 $83,261.67 -267.00 $-267.00 0.00 0.00 0.00 6.90 0.01 0.00 35,000.00 1,344.00 $36,350.91 $119,345.58 -20,600.00 19,771.52 827.93 -0.55 $ -0.55 Cash Basis Tuesday, October 22, 2024 11:38 AM GMT-07:00 1/3 SOUTH KITSAP CHAMBER OF COMMERCE Balance Sheet As of October 22, 2024 TOTAL Other Assets PayPal Sales 0.00 Undeposited Braintree 0.00 Total Other Assets $0.00 TOTAL ASSETS $119,345.03 LIABILITIES AND EQUITY Liabilities Current Liabilities Accounts Payable Accounts Payable 0.00 Total Accounts Payable $0.00 Credit Cards American Express 419.74 Charity Charge -634.91 Total Credit Cards $-215.17 Other Current Liabilities BENEVOLENT FUND 92.72 Direct Deposit Liabilities 0.00 Direct Deposit Payable 0.00 Due to Capital Imrovment 0.00 ECON-DEV COMM 0.00 Education Fund 276.00 Payroll Liabilities 626.97 FICA 1,783.31 FUTA 99.00 L&I 93.47 PFML -303.78 SUTA 89.47 WA Cares Fund 192.91 Total Payroll Liabilities 2,581.35 Prepaid Lunches 0.00 Total Other Current Liabilities $2,950.07 Total Current Liabilities $2,734.90 Long -Term Liabilities EDIL 0.00 SBA PPP 0.00 Total Long -Term Liabilities $0.00 Total Liabilities $2,734.90 Cash Basis Tuesday, October 22, 2024 11:38 AM GMT-07:00 2/3 SOUTH KITSAP CHAMBER OF COMMERCE Balance Sheet As of October 22, 2024 TOTAL Equity EQUITY 0.00 Capital Improv Equity 0.00 Economic Development Equity 0.00 General Equity 0.00 Marketing Equity 0.00 Navigator Restricted Funds Beginning Navigator Fund balanc 25,503.39 Earnings on Navigator funds 42,374.21 Navigator dues - current year 12,625.00 Total Navigator Restricted Funds 80,502.60 Total EQUITY 80,502.60 Opening Bal Equity 0.00 Retained Earnings 88,684.13 Net Income -52,576.60 Total Equity $116,610.13 TOTAL LIABILITIES AND EQUITY $119,345.03 Cash Basis Tuesday, October 22, 2024 11:38 AM GMT-07:00 3/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January - December 2023 TOTAL Income ADVERTISING 25.00 Other Promotion Income 600.00 Profile Enhancements 98.00 Total ADVERTISING 723.00 Annual Member Event Attendee income 50.00 Silent Auction/Raffle 130.00 Table Sponsorships 400.00 Total Annual Member Event 580.00 Chamber Directory Chamber Directory Costs -2,154.37 Chamber Directory Sales 10,476.50 Total Chamber Directory 8,322.13 DUES Regular dues 45,890.30 Total DUES 45,890.30 Grant Projects Specific 8,831.35 Grant Specific Expense -2,717.76 Total Grant Projects Specific 6,113.59 Green Drinks 5,797.86 Green Drink Expense -2,483.75 Green Drinks Promo expense -129.00 Total Green Drinks 3,185.11 INSTALLATION BANQUET Silent Auction/Dessert Auction 40.00 Table Sponsorships 400.00 Total INSTALLATION BANQUET 440.00 Misc Event Sponsorship 500.00 Total Misc Event 500.00 Misc Events 30.00 ALL OTHER Event Income 150.00 Cornhole Classic Expense -3,180.31 Cornhole Income 1,017.00 Cornhole Player Fee 938.12 Cornhole Promotion -353.54 Cornhole Sponsorships 2,600.00 Total Misc Events 1,201.27 Cash Basis Tuesday, October 22, 2024 11:37 AM GMT-07:00 1/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January - December 2023 TOTAL Miscellaneous Income DMJ ONLY Commission Income 5.18 Total Miscellaneous Income DMJ ONLY 5.18 MONTHLY LUNCHEON Attendees Income 9,695.07 Facility charges/meal costs -5,804.68 Misc Luncheon Expenses -48.45 Total MONTHLY LUNCHEON 3,841.94 RAFFLE SALES Raffle sales 1,080.78 Total RAFFLE SALES 1,080.78 SHOP SOUTH KITSAP FIRST S K First - Income 2,500.00 Total SHOP SOUTH KITSAP FIRST 2,500.00 SPONSORSHIPS Sponsorship PC Expense -85.25 Sponsorship PClncome 37,875.00 Total SPONSORSHIPS 37,789.75 TOURISM & PROMOTION LTAC Tourism PROMOTION Exp (reimburseable) 0.00 LTAC TVC Reimbursement 13,464.58 TVC & Promotion Other Income 500.00 Total TOURISM & PROMOTION 13,964.58 Unapplied Cash Payment Income -60.00 Write Offs -5,890.15 Total Income $120,187.48 GROSS PROFIT $120,187.48 Expenses ADMINISTRATION Advertising/Promotion Expense 704.13 Assocation dues & Subscriptions 2,182.40 Education -Chamber Education Expense 2,089.73 Meetings/Events- Chamber attending 950.00 Mileage/Travel 1,601.39 Total ADMINISTRATION 7,527.65 BOARD COMMITTEES Board Committee Expenses 44.81 Education Committee Expense 500.00 Total BOARD COMMITTEES 544.81 BUILDING EXPENSES Kiosk/Business Center 935.00 Cash Basis Tuesday, October 22, 2024 11:37 AM GMT-07:00 2/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January - December 2023 TOTAL Rent 10,803.98 Storage Rentals 2,040.00 Telephone & Internet Services 1,969.23 Total BUILDING EXPENSES 15,748.21 GENERAL OVERHEAD EXPENSES Business License Renewal Fees 110.00 Credit Card Processing Fee 1,779.70 Insurance Liability -Officers 1,324.00 Total Insurance 1,324.00 Internet Support Services- SAAS 3,985.60 Legal and Accounting 2,025.00 NSF Checks- Amount of fee only 6.00 Website 4,970.14 Total GENERAL OVERHEAD EXPENSES 14,200.44 OFFICE EXPENSES Copier Lease 2,559.03 Office Purchases 994.62 Postage 348.00 Printing 210.79 Supplies 132.97 Total OFFICE EXPENSES 4,245.41 Payroll FICA expense 6,405.54 FUTA expense 98.79 L&I expense 266.69 Payroll Expenses 275.44 Payroll otherwise accounted for -524.10 Salaries & wages 83,732.36 SUTA expense 227.63 Total Payroll 90,482.35 Program Expense 207.64 Total Expenses $132,956.51 NET OPERATING INCOME $-12,769.03 Other Income Covid 19 Other Grants 37,957.78 Interest income 18.25 Total Other Income $37,976.03 NET OTHER INCOME $37,976.03 NET INCOME $25,207.00 Cash Basis Tuesday, October 22, 2024 11:37 AM GMT-07:00 3/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January 1 - October 22, 2024 TOTAL Income ADVERTISING Profile Enhancements 98.00 Total ADVERTISING 98.00 DONATIONS 100.00 DUES 480.00 Regular dues 29,870.50 Total DUES 30,350.50 Grant Projects Specific -3,333.60 Grant Specific Expense -2,550.85 Total Grant Projects Specific -5,884.45 Green Drinks 2,673.00 Green Drink Expense -318.75 Total Green Drinks 2,354.25 Misc Event Sponsorship 4,000.00 Total Misc Event 4,000.00 Misc Events 10.00 Cornhole Classic Expense -1,669.98 Cornhole Income 1,890.00 Cornhole LTAC Reimbursement -652.57 Cornhole Player Fee 690.00 Cornhole Promotion -1,829.64 Cornhole Sponsorships 1,000.00 Event Income 200.00 Total Misc Events -362.19 MONTHLY LUNCHEON Attendees Income 8,416.00 Charitable Donations (raffle related) 0.00 Facility charges/meal costs -8,411.04 Misc Luncheon Expenses -57.69 Raffle Sales -788.00 Total MONTHLY LUNCHEON -840.73 RAFFLE SALES Raffle sales 1,005.00 Total RAFFLE SALES 1,005.00 SEAGULL CALLING FESTIVAL Seagul Fest- Reimburseable Exp -364.12 Total SEAGULL CALLING FESTIVAL -364.12 Cash Basis Tuesday, October 22, 2024 11:36 AM GMT-07:00 1/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January 1 - October 22, 2024 TOTAL SHOP SOUTH KITSAP FIRST S K First - Income 2,561.04 Total SHOP SOUTH KITSAP FIRST 2,561.04 SPONSORSHIPS Sponsorship PClncome 15,500.00 Total SPONSORSHIPS 15,500.00 TOURISM & PROMOTION LTAC Tourism Pro- Reimbursement 10,650.67 LTAC Tourism PROMOTION Exp (reimburseable) -2,354.00 LTAC TVC Reimbursement 6,704.57 Total TOURISM & PROMOTION 15,001.24 Total Income $63,518.54 GROSS PROFIT $63,518.54 Expenses ADMINISTRATION Advertising/Promotion Expense 1,562.90 Assocation dues & Subscriptions 1,101.87 Education -Chamber Education Expense 1,155.66 Meetings/Events- Chamber attending 464.67 Mileage/Travel 449.98 Total ADMINISTRATION 4,735.08 BUILDING EXPENSES -70.00 Kiosk/Business Center 640.00 Rent 9,986.32 Repairs 54.60 Storage Rentals 2,040.00 Telephone & Internet Services 1,709.16 Utilities/Cell Phone 37.04 Total BUILDING EXPENSES 14,397.12 GENERAL OVERHEAD EXPENSES Bank Charges 34.00 Business License Renewal Fees 60.00 Credit Card Processing Fee 1,225.31 Insurance 552.08 Liability -Officers 607.50 Total Insurance 1,159.58 Internet Support Services- SAAS 7,300.73 Legal and Accounting 2,640.00 Website 3,060.12 Total GENERAL OVERHEAD EXPENSES 15,479.74 Cash Basis Tuesday, October 22, 2024 11:36 AM GMT-07:00 2/3 SOUTH KITSAP CHAMBER OF COMMERCE Profit and Loss January 1 - October 22, 2024 TOTAL OFFICE EXPENSES Copier Lease 2,128.17 Office Purchases 2,534.10 Postage 68.00 Supplies 141.91 Total OFFICE EXPENSES 4,872.18 Payroll FICA expense 5,360.29 FUTA expense 99.00 L&I expense 216.59 Payroll Expenses 423.28 Salaries & wages 70,069.16 SUTA expense 185.99 Total Payroll 76,354.31 Purchases 239.31 TAXES 32.31 Total Expenses $116,110.05 NET OPERATING INCOME $-52,591.51 Other Income Interest income 14.91 Total Other Income $14.91 NET OTHER INCOME $14.91 NET INCOME $-52,576.60 Cash Basis Tuesday, October 22, 2024 11:36 AM GMT-07:00 3/3 2023 EXEMPT ORG. RETURN PORT ORCHARD CHAMBER OF COMMERCE 1014 BAY STREET #3 PORT ORCHARD, WA 98366-5243 DAWN M JAKE CPA PLLC 420 CLINE AVE PORT ORCHARD, WA 98366 (360)329-7090 DAWN M JAKE CPA PLLC 420 CLINE AVE PORT ORCHARD, WA 98366 (360) 329-7090 March 20, 2024 PORT ORCHARD CHAMBER OF COMMERCE 1014 BAY STREET #3 PORT ORCHARD, WA 98366-5243 Dear Client: Your 2023 Federal Return of Organization Exempt from Income Tax will be electronically filed with the Internal Revenue Service upon receipt of a signed Form 8879-TE - IRS a -file Signature Authorization. No tax is payable with the filing of this return. Please be sure to call us if you have any questions. Sincerely, r Dawn M Jake, PA 2023 Federal Exempt Organization Tax Summary (EZ) Page 1 PORT ORCHARD CHAMBER OF COMMERCE 91-05196131 2023 2022 Diff FORM 990-EZ REVENUE Contributions, gifts, and grants....,..,.... 46,789 0 46,789 Program service revenue,.... .... 9, 695 9,240 455 Membership dues and assessments .... ,.,..... 45,890 51,116 -5,226 Investment income .... ..... . . . ........... . 18 16 2 Net income (loss) - special events......... 64,343 62,522 1,821 Total revenue ...... ..... ....... .. 166,735 122,894 43,841 EXPENSES Salaries and employee benefits.... ........ 90,482 83,787 6,695 Professional fees/pymt to contractors,, 2,025 4,218 -2,193 Occupancy/rent/utilities/maintenance.,,.,. 13,779 13,072 707 Printing, publications, and postage,..... 559 1,125 -566 Other expenses.....,, .. ...................... 34,683 30,688 3,995 Total expenses .. . .. . .............. ... ...... 141,528 132,890 8, 638 NET ASSETS OR FUND BALANCES Excess or (deficit) for the year............ 25,207 -9,996 35,203 Net assets/fund bal. at beg. of year..... 101,606 111,602 -9,996 Net assets/fund bal. at end of year...,.. 126,813 101,606 25,207 2023 General Information Page 1 PORT ORCHARD CHAMBER OF COMMERCE 91-051961 Forms needed for this return Federal: 990-EZ, Sch G, Sch 0 Carryovers to 2024 None 2023 Preparer a -file Instructions - Federal Page 1 PORT ORCHARD CHAMBER OF COMMERCE 91-05196131 The organization's Federal tax return is NOT FINISHED until you complete the following instructions. Prior to transmission of the return Form 990-EZ The organization should review their Federal Return along with any accompanying schedules and statements. Paperless a -file The organization should read, sign and date the Form 8879-TE, IRS e-file Signature Authorization. Even Return No payment is required. After transmission of the return Receive acknowledgement of your a -file transmission status. Within several hours, access the program and get your first acknowledgement (ACK) that the program has received your transmission file. Access the program again after 24 and then 48 hours to receive your Federal ACKs. Keep a signed copy of Form 8879-TE, IRS a -file Signature Authorization in your files for 3 years. Do not mail: Form 8879-TE IRS e-file Signature Authorization 2023 Federal Worksheets Page 1 PORT ORCHARD CHAMBER OF COMMERCE 91-05196131 Special Events Worksheet Less Less Net Gross Contri- Gross Direct Income Special Event Receipts butions Revenue Expenses or Loss CORNHOLE CONTEST $ 23,630. $ 0. $ 23,630. $ 3,534. $ 20,096, ANNUAL MEMBER EVENT 19,915. 0. 19,915. 0. 19,915. Subtotal $ 43,545. $ 0. $ 43,545. $ 3,534. $ 40,011. TOURISM & PROMOTION 13,965. 0. 13,965. 5,950. 8,015. MISC LOCAL EVENTS 10,607. 0. 10,607. 2,613. 7,994. CHAMBER DIRECTORY 10,477. 0. 10,477. 2,154. 8,323. *Subtotal $ 35,049. $ 0. $ 35,049. $ 10,717. $ 24,332. Total $ 78,594. S 0. $ 78,594. $ 14,251. $ 64,343. *Events combined on the return as the third event. k ) a @ ° Q ) j ) ° 2 � ) \ ) � LL 0 5 z e � \CL ); o \ #E) § 2 dk L ± E j) / ^ �) 2) , e!k§eGm}6 ( S S amkeeym}!�} E�; S4e§eRm}s�( G�« \\ / \\\\}\\\\ )_ t«)()) [f}®®§ \±(®*} §\7®»\ ©«e#�2 �2 \/\(§( \\\{\\ a § ° � ) )\\\ 5Ke } 4 7 ` 2 2 § § § � )k)} o / / 0 E _ 2 § \ § j) � ) ° C ^ �) �}\\\ 2 )_�� Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501(e), (except or private ou cl the Internal Revenue Code (except private fio�undations) dine No ,sas-oon7 2023 Do not enter social security numbers on this form, as it may be made public. department of the Treasury Internal Revenue service Go to wwwdrs.gov7Fornil for instructions and the latest information. Open to Public Inspection.. A For the 2023 calendar year, or tax year beginning - , 2023, and ending B Check If applicable: ❑ Address change Name change C PORT ORCHARD CHAMBER OF COMMERCE D Employer Identification number 91-0519613 ❑ Initial return Aral return/terminated 1014 PORT BAY STREET #3 ORCHARD, WA 98366-5243 E Telephone number (360) 876-3505 Amended return Appl,eaton pending F Group NumbeExemption G Accounting Method: ❑g Cash ❑Accrual Other (specify): H Check if the organization is not 1 Website: WWW. pORTORCHARD. COM required to attach Schedule B J Tax-exempt status (check only one) — 501(c)(3) X❑ 501(c) ( 6) (insert no.) ❑ 4947(a)(1) or ❑ 527 (Form 990). K Form of organization: Corporation ❑ Trust ❑ Association Other: L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, column (B)) are $500,000 or more, file Form 990 instead of Form 990-FZ..... ................ $ 180 986. Part I Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part 1) Check if the organization used Schedule O to respond to anv auestion in this Part I.................. . ................ n 1 Contributions, gifts, grants, and similar amounts received ............................................. 1 46,789. 2 Program service revenue including govemment fees and contracts ..................................... 2 9,695. 3 Membership dues and assessments.................................................................. 3 45,890. 4 Investment income................................................................................. 4 - 18. 5a Gross amount from sale of assets other than inventory, ................. 5a b Less: cost or other basis and sales expenses ............................. 56 e Gain or (loss) from sale of assets other than Inventory (subtract line 5b from line 5a).................................. 5c 6 Gaming and fundraising events: 3 y we a Gross income from gaming (attach Schedule greater than $15.000)..... 6a b Gross income from fundraising events (no I ing of contributions from fundraising events reported on line 1 (att h Chei-clnumcc of such gross income and contributions a $156bi 78,594. c Less: direct expenses from gaming and fundraising events ................ 6cl 14,251. d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c)............................................................................. 7a Gross sales of inventory, less. returns and allowances ... . . ................ 7a 6d 64,343. b Less: cost of goods sold ................................................ 7b c Gross profit or (loss) from sales of inventory (subtract line 7b from line 7a)............................. 8 Other revenue (describe in Schedule 0).... _.................................. 7c 8 9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8...... ..... ........... . ....................:....... 9 166 735. 10 Grants and similar amounts paid (list in Schedule O).................................................. 10 11 Benefits paid to or for members..................................................................... 11 m g Ul 12 Salaries, other compensation, and employee benefits. , ................... ........................... 13 Professional fees and other payments to independent contractors.. ......... . ontractors.................................. 14 Occupancy, rent, utilities, and maintenance ...... ........._..............................,.......... 15 Printing, publications, postage, and shipping .................... 16 Other expenses (describe in Schedule 0)................................See Schedule 0 17 Total expenses. Add lines 10 through 16............................................................. 12 90,482. 13 2 025.. 14 13,779. 15 559. 18 34,683. 17 141 528. z20 18 Excess or (deficit) for the year (subtract line 17 from line 9)........................................... 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end -of -year figure reported on prior year's return)........ .................................. Other changes in net assets or fund balances (explain in Schedule 0) ..... 4 ....................... I ... 21 Net assets or fund balances at end of year. Combine lines 18 through 20..... 4 ....................... 18 25,207. 19 101 606. 20 21 126 813. xa . rur raperwork Reduction Act nonce, see line separate instructions. Form 990-EZ (2023) TEEA0812L 08/07/23 Form 990-EZ Page 2 (A) Beginning of year (B) End of year 22 Cash, savings, and investments .................................................. .. 23 Land and buildings................................................................ See Schedule 0 24 Other assets (describe in Schedule 0), ................. ........................... 25 Total assets ........................................ . .......................... 26 Total liabilities (describe inSchedule 0)......... See.Schedule.0 27 Net assets or fund balances (line 27 of column (B) must agree with line 21) .. 145 407.1221 170.7 818. 14 a726 171 551. 4 44 738. 10 126 813. Fart III ' Statement of Program Service Accomplishments (see the instructions for Part III) ® Check if the organization used Schedule 0 to respond to any question in this Part III ............. Expenses ((Required for section 501 (c)(3) and 501(c)(4) organizations; optional for others.) What is the organizabon's primary exempt purpose? See Schedule 0 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title. 29 PROMOTE BUSINESS IN THE COMMUNITY ---------------------------------------------------- This-- ----This—This--This---g-9--- (Grants � ) If this amount includes forei n rants, check here ............... 28a 29 ---------------------------------------------------- (Grants ..7 7 ...... $ ) If this amount includes foreign grants, check here..... 29a 30 ---------------------------------------------------- This.—$— —�---This--------g-9 --This— This--------- Grants If this amount includes foren rants, check here .................. I 30a 31 Other program services (describe in Schedule 0)..:...... ............................................. .. (Grants $ ) If this amount includes foreign grants, check here .................. ❑ 31a 32 Total program service expenses (add lines 28athrough 31a)............................................ 32 r rsd List oT Officers, Directors, Trustees, and Key Employees (list each one even if not compensated — see the instructions for Part IV) El if the organization used Schedule 0 to respond to any question in this Part IV ........................................ (a) Name end title (b) Average hours per week devoted to position (o) Reportable compensation (Fors W 2/l 099-MISI I099-NEC) (If not paid, enter -a-) (d) Health benefits, contributions to employee benefit plans, and deferred mmpensahon (a) Estimated amount of other compensation TRINETTE GATES__________ President 5 0. 0. 0. DAWN JAKE -------------------- Tr - easurer 3 0. 0. 0. JENNIFER HARDISON --------------------- Secretary 3 0. 0. 0. ROBERT MCGEE --------------------- Chairman 5 0. 0. 0. CODY CLARK _ _ _ _ _ _ _ Executive Direc 50 0. 0. 0. ---------------------- ---------------------- ---------------------- ---------------------- ---------------------- --------------------- --------------------- BAA TEEA0812- 08/07/23 firm 11,ofv l Form 990-EZ (2023) PORT ORCHARD CHAMBER OF COMMERCE 91-0519613 Page 3 RaetV Other Information (Note the Schedule A and personal benefit contract statement requirements in ❑ the instructions for Part V.) Check if the organization used Schedule 0 to respond to any question in this Part V. .......... Yes No 33 Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule 0............................................... 33 X 34 Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule 0. See instructions ........................................ 34 X 35a Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ................. ................................... 35a X b If "Yes" to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule 0 35b c Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III . ....... ............ 35c X 36 Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicable parts of Schedule N................... ....... 36 X 37a Enter amount of political expenditures, direct or indirect, as described in the instructions.. I 37a 1 0 . b Did the organization file Form 1120-POL for this year?. . . .... ............................ ............... 37b X 38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee; or were any such loans made in a prior year and still outstanding at the end of the tax year covered by this return? ............ 38a X b If "Yes,' complete Schedule L, Part II, and enter the total amount involved .............. ... ..... 38bl 0 39 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on line 9............ .......... 39a 0 , b Gross receipts, included on line 9, for public use of club facilities ........................ 3911a0. 40a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under: N/A section 4911 : 0 . ; section 4912: 0 ; section 4955: 0. b Section 501(c),3), 501(c)(% and 501(c)(29) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part t ...................... _ ... _ 40b c Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ........ 0. d Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax on line 40c reimbursed bythe organization......................................................... I ............ .,. 0 . e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If"Yes," complete Form 8886-T.............................................................. 40e X 41 List the states with which a copy of this return is filed: None 42a The organization's books are in care of: CODY CLARK Telephone no. (360)_876-3505 Located at: 1014 SAY-STR=F3PORT-ORCHARD-W---- ZIP+4 — — --- ______________ 98366_ ------------------- -- b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No financial account in a foreign country (such as a bank account, securities account, or other financial account)?......... 421[b X If "Yes," enter the name of the foreign country: See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). c At any time during the calendar year, did the organization maintain an office outside the United States? ............ 42c X If "Yes," enter the name of the foreign country: 43 Section 491 nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 — Check here........ .. ......... N/A and enter the amount of tax-exempt interest received or accrued during the tax year ......... ..... 143 N/A 44a Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead ofForm 990-EZ................................................. _............,.......................,,,.....,.. b Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completed insteadof Form 990-E7 ............................ _ ................. _..................................,,...,.. c Did the organization receive any payments for indoor tanning services during the year?. . ............................ of If "Yes" to line 44c, has the organization filed a Form 720 to report these payments? If "No." provide an explanation in Schedule 0...................................................................... 45a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ............................. b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes,' Form 990 and Schedule R may need to be completed instead of Form 990-EZ. See instructions ............................................ TEEA0812L 0ei07123 Form 990-EZ (2023) Form 990-EZ COMMERCE Page 4 > No 46 Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I ...................................... . ............ F Section 501(cx3) Organizations Only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51. Check if the organization used Schedule O to resbond to anv question in this Part VI........ l 47 Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part If ..................................................................................... 48 Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ................... 49a Did the organization make any transfers to an exempt non -charitable related organization? . ........ ........ ........... b If "Yes," was the related organization a section 527 organization? ................................................... 50 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees, and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None." (a) Name and title of each employee (b) Average hours per week devoted to position (c) Reportable compensation (Forms W-211099-MISCI 109MEC) (d) Health benefits, contributions to employee benefit plans, and deferred compensation (a) Estimated amount of other compensation t total number or other employees paid over $IUU,000......... 51 Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None.' (a) Name and business address of each independent contractor I (b)Type of service I (c) Compensation d Total number of other independent contractors each receiving over $100,000................. I................. 52 Did the organization complete Schedule A? Note: All section 501(c)(3) organizations must attach a completedSchedule A.................................................................................... [I Yes No 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 orecarer has anv knowledge. Sign Here Signature of officer CODY CLARK Data Executive Direc Type or print name and title Paid Printrrype preparers name Dawn M Jake CPA Preparer's signature Dawn M Jake CPA Date ❑ self -employe: PTIN p00365238 Preparer Use Only Firm's name Dawn M Jake CPA PLLC Fir sEIN 20-0433597 Firm 'aaddress 420 Cline Ave ina I ned'B : Port Orchard WA 98366 Wn a e, C.P.A. Phone no, 360 329-7090 May the IRS discuss this return with the preparer shown above? See instructions ......................................... ❑}( Yes ❑ No BAA Form 990-EZ (2023) TEEA0812L 08/07/23 SCHEDULE G Supplemental Information Regarding Fundraising or Gaming Activities (Form DU 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. Department of the Treasury Attach to Form 990 or Form 990-EZ. Internal Fovc,.e Service I Go to www.1rs.gov1Form990 for instructions and the latest information. ORCHARD CHAMBER OF COMMERCE 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. 91-0519613 OMB No. 1545-0047 Open to Public Inspection number 1 Indicate whether the organization raised funds through any of the following activities. Check all that apply. a Mail solicitations e Solicitation of non -government grants b Internet and email solicitations f Solicitation of government grants c ❑ Phone solicitations g ❑ Special fundraising events d ❑ In -person solicitations 2a 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? .................. ❑Yes El No 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. (i) Name and address of individual or entity (fundraiser) (i) Activity (iii) Did fundraiser have custody or control of contributions. (iv) Gross receipts from activity (v) Amount paid to (or retained by) fundraiser listed in column (i) (vi)) Amount paid to. (or retained by) organization 1 Yes No 2 3 4 5 6 7 8 9 10 Total................................................................. o usi au siaies in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing. ----------------------------------------------------------------- BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 99(l Schedule G (Form 990) 2023 TEEA3701L 06/08/23 Schedule G (Form 990) 2023 PORT ORCHARD CHAMBER OF COMMERCE 91-0519613 Page 2 Part 11 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 CORNHOLE CONTE ANNUAL MEMBER 3 (add column a through column f c)) (event type) (event type) (total number) to 23,630. 19,915. 35,049. 78,594. C 1 Gross receipts ......................... cc 2 Less: Contributions .................... 23,630. 19,915. 35,049. 78,594. 3 Gross income (line 1 minus line 2)...... 4 Cash prizes ........................... 5 Noncash prizes, ....................... N 6 Rent/facility costs ...................... C N �- 7 Food and beverages ................... w Y � B Entertainment.... ................... 14,251. 9 Other direct expenses .................. 3,534. 10,717. 10 Direct expense summary. Add lines 4 through 9 in column(d)............................................. 14 251 . 11 Net income summary. Subtract line 10 from line 3, column(d)............................................. 64, 343. Part III 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. (b) Pull tabs/instant (d) Total gaming (a) Bingo bingo/progressive (c) Other gaming (add column (a) bingo through column (c)) N tY 1 Gross revenue ......................... 2 Cash prizes ........................... a G a3 Noncash prizes..::....., .............. w a+ 4 Rent/facility costs ...................... 5 Other direct expenses .................. Yes % Yes Yes % 6 Volunteer labor ........................ I INo No I INo . 7 Direct expense summary. Add lines 2 through 5 in column (d)............................................ 8 Net gaming income summary. Subtract line 7 from line 1, column (d)...................................... 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 weYe any of the organization's gaming licenses revoked, suspended, or terminated during the tax year?............ ❑ Yes No b If "Yes," explain: ----------------------------------------------------------------- BAA TEEA3702L 06/08/23 Schedule G (Form 990) 2023 Schedule G (Form 990) 2023 PORT ORCHARD CHAMBER OF COMMERCE 91-0519613 Pagr 11 Does the organization conduct gaming activities with nonmembers? ..... -.. -................................... Yes n 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 F No 13 Indicate the percentage of gaming activity conducted in: a The organization's facility............................................................................... I 13a $ b An outside facility...................................................................................... I 13 b % 14 Enter the name and address of the person who prepares the organization's gaming/special eventsbooks 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 theamount of gaming revenue retained by the third party $ e If "Yes," enter name and address of the third party: Name ----------------------------------------------------1 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.. $ lines 9, 9b, 1Ob, 15b, 15c, 16, and 17b, as See instructions. i provide any BAA TEEA3703L 06/08/23 Schedule G (Form 990) 2023 SCHEDULE O (Form 990) Department of the Treasury nternal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ Complete to de information for responses to specific questions on Form provi0 or 990•EZ or to provide any additional information. Attach to Form 990 or Form 990-EZ. Go to www.irs.gov1Form990 for the latest information. OMB No. 1545-0047 1 2023 Employer identi(cati 91-0519613 Form 990-EZ, Part I, Line 16 Other Expenses Advertising and Promotion................................................................. $ 704. ASSOCIATION DUES.............................................................................. 2,182. BANK SERVICE CHARGES......................................................................... 6. CAPITAL EXPENDITURES.......................................................................... 995. COMMITTEE EXPENSE............................................................................... 545. COPIERLEASE ....................... .-... ................................ ......................... 2,559. EDUCATION........................................................................................... 2,090. GRANT SPECIFIC EXPENSE....................................................................... 2,718. Insurance,.......................................................................................... 1,324. INTERNET SUPPORT SERV......................................................................... 3,986. LICENSE RENEWAL.................................................................................. 110. MEETINGS., ........................................... ............................................... 950. MONTHLY LUNCHEON................................................................................ 5,853. PROCESSINGFEES.................................................................................. 1,780. PROGRAM SUPPLIES- ................ .............................................................. 208. SUPPLIES............................................................................................. 133. TELEPHONE.......................................................................................... 1,969. Travel............................................................................................. 1,601. WEBSI TE............................................................................................. 4 970 . Total 34,683. Form 990-EZ, Part II, Line 24 Other Assets Beginning_ Ending LUNCHEON MONEY DUE............................................................. $ 1 069. $ 818. Total 1,069. 818. Form 990-EZ, Part II, Line 26 Total Liabilities Beginning_ Ending BENEVOLENTFUND.................................................................. $ 93. $ 93. CREDITCARD........................................................................ 286. 130. EDUCATIONFUND ............................................ ...................... 276. 276. PAYROLL LIABILITIES............................................................ 1,841. 1,865. UNREALIZED GAIN...... ... ....................... 42 374. 42 374. Total 44,870. 44,738. Form 990-EZ, Part III - Organization's Primary Exempt Purpose PROMOTE BUSINESS IN THE COMMUNITY BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. TEEA4901L 07124123 Schedule 0 (Form 990) 2M Form 8879-TE IRS E-file Signature Authorization OMB No, tsar-0047 for a Tax Exempt Entity For calendar year 2023. or fiscal year beginning , 2023. and ending _ _ _ 20 ^ O ^ ^ Department of the Treasury Do not send to the IRS. Keep for your records. L Ls Internal Revenue service Go to www.Irs.gov1Forrr18879TE for the latest information. Name of filer EIN or SSN PORT ORCHARD CHAMBER OF COMMERCE 91-0519613 Name and title of officer or person subject to tax CODY CLARK Executive Direc Wow —Type of Return and Return Information Check the box for the return for which you are using this Form 8879-TE and enter the applicable amount, if any, from the return. Form 8038-CP and Form 5330 filers may enter dollars and cents. For all other forms, enter whole dollars only. If you check the box on line la, 2a, 3a, 4a, 5a, 6a, 7a, Sa, 9a, or 10a below, and the amount on that line for the return being filed with this form was blank, then leave line 1b, 2b, 3b, 4b, 5b, 6b, 7b, 8b, 9b, or 10b, whichever is applicable, blank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on the applicable line below. Do not complete more than one line in Part I, la Form 990 check here..... b Total revenue, if any (Form 990, Part VIII, column (A), line 12)............ 1b 2a Form 990-EZ check here.. g b Total revenue, if any (Form 990-EZ, line 9) ............................. I 2b 166, 735. 3a Form 1120-POL check here b Total tax (Form 1120-POL,line 22)...................................... 3b 4a Form 990-PF check here.. b Tax based on investment Income (Form 990-PF, Part V, line 5), .......... 4b 5a Form 8868 check here.... b Balance due (Form 8868,line 3c)................................ ...... 5b 6a Form 990-T check here, .. b Total tax (Form 990-T, Part ill, line 4) • • • • 6b 7a Form 4720 check here.... b Total tax (Form 4720, Part lll,line 1).................................... 7b Sa Form 5227 check here.... b FMV of assets at end of tax year (Form 5227, Item D) .................... Sb 9a Form 5330 check here.... b Tax due (Form 5330, Part 11,line 19).................................... 9b 10a Form 8038-CP check here. b Amount of credit payment requested (Form 8038-CP, Part III, line 22) .... 10b P'"`; ..I Declaration and Signature Authorization of Officer or Person Subject to Tax Under penalties of perjury, I declare that L`J I am an officer of the above entity or U I am a person subject to tax with respect to (name of entity) (EIN) and that I have examined a copy of the 2023 electronic return and accompanying schedules and statements, and, to the best of my knowledge and belief, they are true, correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of the electronic return. I consent to allow my intermediate service provid transmitter, or electronic return originator (ERO) to send the return to the IRS and to receive from the IRS (a) an acknowledgement of rec '5in rea the transmission, (b) the reason for any delay in processing the return or refund, and (c)the date of any refund. If ap ca or asury and its designated Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the fins ia'tut a o ed in the tax preparation software for payment of the federal taxes owed on this return, and the financial instit .deb to is account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial institutions involved In the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I have selected a personal identification number (PIN) as my signature for the electronic return and, if applicable, the consent to electronic funds withdrawal. PIN: check one box only Fx I authorize Dawn M Jake CPA PLLC to enter my PIN 15701 as my signature ERO firm name Enter five numbers, but do not enter all zeros on the tax year 2023 electronically filed return. If I have indicated within this return that a copy of the return is being filed with a state agency('es) regulating chanties as part of the IRS Fed/State program, I also authorize the aforementioned ERO to enter my PIN on the return's disclosure consent screen. ❑ As an officer or person subject to tax with respect to the entity, I will enter my PIN as my signature on the tax year 2023 electronically filed return. If I have indicated within this return that a copy of the return is being filed with a state agency(jes) regulating charities as part of the IRS Fed/State program, I will enter my PIN on the return's disclosure consent screen, Signature of officer or person subject to tax Date NOW Certification and Authentication ERO's EFIN/PIN. Enter your six -digit electronic filing identification number (EFIN) followed by your five -digit self-selected PIN. 91049833597 Do not enter all zeros I certify that the above numeric entry is my PIN, which is my signature on the 2023 electronically filed return indicated above. I confirm that I am submitting this return in accordance with the requirements of Pub.4163, Modernized a -File (MeF) Information for Authorized IRS a -file Providers for Business Returns. ERO's signature Dawn M Jake, CPA Date 3/20/2024 ERO Must Retain This Form — See Instructions Do Not Submit This Form to the IRS Unless Requested To Do So BAA For Privacy and Paperwork Reduction Act Notice, see instructions. TEEA8800L 11n7/23 Form 8879-TE (2023)