SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
PUGET SOUND KIDNEY CENTERS FOUNDATION
 
Employer identification number

45-4354877
Return Reference Explanation
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME DESCRIPTION: DIVIDENDS. AMOUNT: 6,711. DESCRIPTION: CAPITAL GAINS. AMOUNT: 251. DESCRIPTION: INTEREST. AMOUNT: 6. TOTAL INCLUDED ON FORM 990-EZ, LINE 4: 6,968.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: TO SUPPORT NUTRITIONAL SUPPLEMENTS AND EQUIPMENT FOR PATIENT CARE.. GRANTEE NAME: PUGET SOUND KIDNEY CENTERS. GRANTEE ADDRESS: 1019 PACIFIC AVENUE EVERETT, WA 98201. GRANTEE RELATIONSHIP: SUPPORTED ORGANIZATION. PROPERTY DESCRIPTION: CASH. AMOUNT GIVEN: 18,308.
FORM 990-EZ, PART I, LINE 14 DESCRIPTION: DEPRECIATION. AMOUNT: 1,058.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: LICENSE. AMOUNT: 40. DESCRIPTION: OTHER. AMOUNT: 445. DESCRIPTION: INVESTMENT EXPENSE. AMOUNT: 4. DESCRIPTION: IN-KIND EXPENSE: FOOD AND SUPPORT FOR ANNUAL PATIENT PICNIC. AMOUNT: 2,713. TOTAL TO FORM 990-EZ, LINE 16: 3,202.
FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS DESCRIPTION: UNREALIZED GAIN. AMOUNT: 53,493.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: PLEDGES RECEIVABLE. BEG. OF YEAR AMOUNT: 3,250. END OF YEAR AMOUNT: 12,593. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 4,671. END OF YEAR AMOUNT: 3,614.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: ACCRUED EXPENSE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 12,308.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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