2025-08-14T13:20:56-05:00 2024-09-30 911301672 SWEENEY CONRAD PS 10210 NE POINTS DRIVE SUITE 300 KIRKLAND WA 98033 990 2023-10-01 814004703 CENTER FOR ADVANCED MANUFACTURING PUGET SOUND HEALTH TRUST CENT 4256417762 15375 SE 30TH PL SUITE 380 BELLEVUE WA 98007 KIRK DAVIS EXECUTIVE DIRECTOR, TRUSTEE 4256417762 2025-08-13 1 0 KRISTINA MORRISSETTE P01242961 4256291990 2025-08-13 2023 2025-03-06 01:10:19Z KIRK DAVIS 15375 SE 30TH PL SUITE 380 BELLEVUE WA 98007 18371217 0 X N/A X 2016 WA TO PROVIDE HEALTH AND OTHER BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 3 0 0 0 0 0 0 0 19167585 18315103 17717 56114 0 0 19185302 18371217 0 0 17443268 17784203 0 0 0 0 0 486373 502034 17929641 18286237 1255661 84980 2734699 3020300 678701 879322 2055998 2140978 TO PROVIDE HEALTH AND OTHER BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS. 0 0 18286237 THE PLAN PROVIDES HEALTH AND OTHER BENEFITS FOR ELIGIBLE EMPLOYEES AND THEIR DEPENDENTS ACCORDING TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA) 18286237 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 X EPK & ASSOCIATES INC 4256417762 15375 SE 30TH PLACE SUITE 380 BELLEVUE WA 98007 KIRK DAVIS EXECUTIVE DIRECTOR, TRUSTE 1.00 40.00 X X 0 151777 9473 SINA VAN SCOYOC TRUSTEE 1.00 40.00 X 0 0 0 DEANNA HELLAND TRUSTEE 1.00 40.00 X 0 0 0 0 151777 9473 0 0 1 0 EPK & ASSOCIATES INC 15375 SE 30TH PLACE 380 BELLEVUE WA 98007 ADMINISTRATIVE SERVICE PROVIDER 396097 1 CONTRIBUTIONS 900099 18150644 18150644 COBRA CONTRIBUTIONS 900099 164459 164459 18315103 56114 56114 18371217 18315103 0 56114 17784203 17784203 396097 396097 24000 24000 23000 23000 39072 39072 6500 6500 12288 12288 WA STATE UNCLAIMED PROP 1077 1077 18286237 18286237 0 0 250000 250000 2392256 2538483 92443 231817 2734699 3020300 678701 879322 678701 879322 X 0 0 0 0 2055998 2140978 2055998 2140978 2734699 3020300 84980 0 X 0 1 X 1 0 0 PREMIUM PAYABLE 879322 879322 X 18371217 0 18371217 0 18371217 18085616 0 18085616 200621 200621 18286237 PART X, LINE 2: THE PLAN RECEIVED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) DATED APRIL 13, 2022, STATING THAT THE PLAN IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). THE BOARD OF TRUSTEES BELIEVES THAT THE PLAN IS CURRENTLY DESIGNED AND BEING OPERATED IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE IRC. THEY BELIEVE THAT THE PLAN WAS TAX-EXEMPT AS OF THE FINANCIAL-STATEMENT DATE; THEREFORE, NO PROVISION FOR INCOME TAX HAS BEEN INCLUDED IN THE PLAN'S FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF THE LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICITIONS, AND THE PLAN COULD BE SUBJECT TO INCOME TAX IF CERTAIN ISSUES WERE FOUND BY THE IRS THAT COULD RESULT IN THE DISQUALIFICATION OF THE PLAN'S TAX-EXEMPT STATUS; HOWEVER, THERE ARE CURRENLTY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN PREMIUM PAYABLE 0 0 0 KIRK DAVIS EXECUTIVE DIRECTOR, TRUSTE 0 151777 0 0 0 0 0 9473 0 0 0 161250 0 0 FORM 990, PART VI, SECTION A, LINE 3 DAY TO DAY OPERATIONS OF THE TRUST ARE DELEGATED TO A THIRD-PARTY ADMINISTRATOR, EPK & ASSOCIATES, INC. THE BOARD RETAINS ULTIMATE RESPONSIBILITY FOR THE OPERATION OF THE TRUST. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT IS REVIEWED AND APPROVED BY THE SIGNING TRUSTEE AND THIRD-PARTY ADMINISTRATOR BEFORE FILING. FORM 990, PART VI, SECTION C, LINE 19 NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. 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