2024-06-04T14:46:11-05:00 2023-12-31 680300457 MACIAS GINI & O'CONNELL LLP 2570 W EL CAMINO REAL 150 MOUNTAIN VIEW CA 94040 990EZ 2023-01-01 831236046 FORUM CHARITABLE FUND FKA FORUM HEALTH FUND FORU 6509889300 23600 VIA ESPLENDOR CUPERTINO CA 95014 PATTI WHITE PRESIDENT 6509889300 2024-05-24 1 PATTI WHITE 999009999 1 FERNANDA AMARAL P01463232 6502091800 3 AAL1 IAL1 2023 2023-04-26 12:10:37Z X WWW.FORUMHEALTHFUND.ORG X X 98686 X 96463 2223 98686 96395 8476 104871 -6185 161852 0 155667 161852 155667 161852 155667 0 0 161852 155667 X THE ORGANIZATION'S PRIMARY PURPOSES ARE 1) TO PROMOTE HEALTHY AGING, INCLUDING COGNITIVE WELLNESS, PAIN MANAGEMENT, SAFETY, EDUCATION, AND ENRICHMENT AND 2) TO SUPPORT INNOVATIONS IN AGING AND 3) TO ENGAGE IN ANY OTHER CHARITABLE ACTIVITY PERTAINING TO SENIORS. TO PROMOTE HEALTHY AGING, INCLUDING COGNITIVE WELLNESS, PAIN MANAGEMENT, SAFETY, EDUCATION, AND ENRICHMENT AND TO SUPPORT INNOVATIONS IN AGING AND TO ENGAGE IN ANY OTHER CHARITABLE ACTIVITY PERTAINING TO SENIORS. 96395 96395 96395 CATHERINE COTTER GRANTS CHAIR 1.00 0 0 0 NADJA JACKSON COMMUNITY RELATIONS 1.00 0 0 0 JOHN MONROE DEVELOPMENT CO-CHAIR 1.00 0 0 0 ED COHEN DEVELOPMENT DIRECTOR 1.00 0 0 0 ROWENA CHOW DEVELOPMENT DIRECTOR 1.00 0 0 0 HOWARD PETERS DEVELOPMENT CO-CHAIR 1.00 0 0 0 PATTI WHITE PRESIDENT 1.00 0 0 0 LIU-JEN CHU SECRETARY 1.00 0 0 0 RUSS FULLER TREASURER 1.00 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CA DIANA O'HALLORAN 1790 WINCHESTER BLVD SUITE 3 CAMPBELL CA 95008 4083788801 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 72471 66408 111453 94561 96463 441356 72471 66408 111453 94561 96463 441356 85164 356192 7 1 119 13 2223 2363 443719 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE DESCRIPTION: INTEREST & DIVIDEND . AMOUNT: 2,223. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GRIEF COUNSELING SERVICES. GRANTEE NAME: KARA. GRANTEE ADDRESS: 457 KINGSLEY AVENUE PALO ALTO, CA 94301. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 04/19/23. AMOUNT GIVEN: 10,000. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: PROGRAM TO ASSIST SENIORS WHO HAVE LOST SIGHT TO LEARN TO PERFORM ACTIVITIES. GRANTEE NAME: VISTA CENTER FOR THE BLIND AND VISUALLY IMPAIRED. GRANTEE ADDRESS: 2500 EL CAMINO REAL, UNIT 100 PALO ALTO, CA 94306. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 07/19/23. AMOUNT GIVEN: 7,650. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: SUPPORT PROGRAMS FOR LOW-INCOME SENIORS WITH MILD TO MODERATE DEMENTIA. GRANTEE NAME: LIVE OAK ADULT DAY SERVICES. GRANTEE ADDRESS: 1147 MINNESOTA AVENUE SAN JOSE, CA 95110. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 11/30/23. AMOUNT GIVEN: 10,000. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: ORG SUPPORTS THOSE PRIMARILY SENIORS, UNABLE TO AFFORD HEARING AIDS & SERVIC. GRANTEE NAME: PACIFIC HEARING CONNECION . GRANTEE ADDRESS: 496 1ST ST STE 120 LOS ALTOS, CA 94022. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 01/17/23. AMOUNT GIVEN: 5,000. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: DIGITAL INCLUSION FOR SENIORS. GRANTEE NAME: ANEW VISTA COMMUNITY SERVICES. GRANTEE ADDRESS: 1201 CARMEL TERRACE LOS ALTOS, CA 94024. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 04/05/23. AMOUNT GIVEN: 9,000. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GRANT FOR HEALTH SUPPORT . GRANTEE NAME: THE FORUM HEALTHCARE CENTER. GRANTEE ADDRESS: 23600 VIA ESPLENDOR CUPERTINO, CA 95014. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 06/20/23. AMOUNT GIVEN: 44,745. FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: GRANT TO HELP SENIORS IN NEED. GRANTEE NAME: COMMUNITY SERVICES AGENCY. GRANTEE ADDRESS: 435 SAN ANTONIO RD MOUNTAIN VIEW, CA 94040. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. DATE OF GIFT: 08/22/23. AMOUNT GIVEN: 10,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 96,395. FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: REGISTRATION FEES. AMOUNT: 55. DESCRIPTION: PROFESSIONAL FEES. AMOUNT: 1,935. DESCRIPTION: PRINTING. AMOUNT: 1,413. DESCRIPTION: INSURANCE. AMOUNT: 972. DESCRIPTION: WEBSITE SERVICES. AMOUNT: 12. DESCRIPTION: SOFTWARE. AMOUNT: 379. DESCRIPTION: BANK SERVICE . AMOUNT: 240. DESCRIPTION: BOOKKEEPING. AMOUNT: 850. DESCRIPTION: OUTSIDE CONTRACT SERVICES. AMOUNT: 500. DESCRIPTION: BOOKS & SUBSSCRIPTIONS . AMOUNT: 1,800. DESCRIPTION: SUPPLIES. AMOUNT: 320. TOTAL TO FORM 990-EZ, LINE 16: 8,476. THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.